Malignant Transformation Of Epidermoid Cysts Research Articles

Squamous cell carcinoma arising in the background of an epidermoid cyst: A case report from Syria

Introduction: Malignant transformation of epidermoid cysts is rare, it accounts for 1% of all diagnosed cysts. Transformation into squamous cell carcinoma and basal cell carcinoma can occur. Clinical examination, radiological examination, and pathological confirmation are necessary for diagnosis and the treatment of choice is usually surgical excision. Case Report: A 57-year-old Syrian female patient presented to our hospital with a huge mass on the back. Computed tomography revealed a subcutaneous huge mass 25.0 × 20.0 × 9.0 cm extended from cervical vertebrae level into upper lumbar vertebrae. Surgery with the intent of wide and complete excision was performed but it was difficult to obtain complete excision of tumor because of extension into the deep muscles. The diagnosis was made by histopathologic examination. It was a malignant transformation into squamous cell carcinoma arising from the epidermoid cyst. The patient received radiotherapy after surgery because of incomplete excision of tumor. Conclusion: This case shows an unusual presentation of a huge epidermoid cyst on the back with transformation into malignancy. We aimed to highlight the importance of early diagnosis and treatment of these cysts.

Treatment and Survival Outcomes of Primary Intracranial Squamous Cell Carcinoma

Primary intracranial squamous cell carcinoma (SCC) is a rare neoplasm associated with malignant transformation of benign epidermoid or dermoid cysts. The optimal treatment and prognosis of this rare disease are unclear. A comprehensive literature review identified all reports relevant to clinical presentation, treatment, and outcome of primary intracranial SCC. All available data were extracted from the included literature. Two patients diagnosed with malignant transformation of an epidermoid cyst in our institute were also included in the study. Survival analysis was conducted to determine the factors affecting patient outcomes. A total of 62 cases were identified and selected for the present study. The median survival regardless of treatment was 12.8 months. Median survival for patients treated with surgery alone and surgery with radiotherapy was 5 months and 35 months, respectively (P= 0.037). Patients who underwent gross total resection showed relatively increased survival compared with those who underwent subtotal resection (median, 48 months vs. 25 months; P= 0.067). Patients with leptomeningeal carcinomatosis had a significantly decreased median survival of 10 months, as opposed to 41 months (P= 0.005). Primary intracranial SCC shows poor prognosis, with controversial management. The results of this study indicate that complete resection of tumor when possible, followed by radiotherapy, is the optimal treatment for improving patient outcome.

Imaging Findings of an Epidermoid Cyst Undergoing Malignant Transformation.

Malignant transformation of epidermoid cyst into squamous cell carcinoma (SCC) is rare. We report the case of a 39-year-old woman presenting with dizziness and cerebellar ataxia. MR scan revealed a mass in the left cerebropontine angle compressing the brainstem and the cerebellum, with two main components, a cystic and a solid one. The cystic component displayed imaging findings consistent with an epidermoid cyst. The solid component showed dense calcifications, low signal intensity on T1W, T2W and DW images and peripheral nodular enhancement. MR spectroscopy detected high lipid/lactate peaks and choline/creatine ratio. Imaging findings raised suspicion for malignant transformation, which was confirmed by histopathologic examination revealing an SCC. MR imaging with intravenous administration of gadolinium, DW images and MR spectroscopy can play a critical role in the diagnosis of malignant transformation of an epidermoid cyst.

Malignant transformation of an intramedullary epidermoid cyst in the thoracic region of the spinal cord

Malignant transformation of epidermoid cysts (ECs) to squamous cell carcinomas (SCCs) in the CNS is exceedingly rare and has only been described in intracranial ECs. In this article, the authors describe a 53-year-old man with a history of a previously resected T3-4 EC, who presented with a 2-month history of progressively worsening weakness in the left side of his body. Magnetic resonance imaging revealed an enhancing mass in the T3-4 region, the exact location of the previous cyst. The mass was resected in gross-total fashion, and pathological analysis revealed an SCC. Postoperatively, the patient regained full strength in his lower extremities. After the resection, he received radiotherapy administered at an isodose of 50 Gy. To the authors' knowledge, this is the first reported case of malignant transformation of an intramedullary spinal EC in the literature.

Malignant Transformation 20 Years After Partial Removal of Intracranial Epidermoid Cyst -Case Report-

A 74-year-old woman presented with malignant progression of remnant epidermoid cyst manifesting as sudden onset of right ptosis and double vision. She had right oculomotor nerve paresis. She had a history of surgery for right cerebellopontine angle epidermoid cyst 20 years previously. T(1)-weighted magnetic resonance (MR) imaging demonstrated a hypointense mass lesion in the right cerebellopontine angle and basal cistern, and an isointense mass in the right paraclinoid region which was strongly enhanced. Diffusion-weighted MR imaging showed hyperintense areas in the right cerebellopontine angle, ambient cistern, and basal cistern, and the paraclinoid mass as hypointense. Surgery was performed using Dolenc's approach. Histological examination revealed that the paraclinoid tumor adjacent to the epidermoid tumor remnant was malignant transformation of epidermoid cyst into squamous cell carcinoma. She was treated with 46 Gy linac radiotherapy. She has been without tumor recurrence for 17 months. Malignant change of epidermoid cyst is extremely rare, but rapid progress of the symptoms suggests malignant transformation. MR imaging with gadolinium is useful for diagnosis.

MR Imaging of a Cerebello-Pontine Angle Epidermoid Cyst with a Malignant Transformation: Case Report

The malignant transformation of an epidermoid cyst can be discovered at the same time as a pre-existing epidermoid cyst, or during a follow-up examination after an incomplete excision. We describe a rare case of malignant transformation of a cerebellopontine angle epidermoid cyst which extended into the middle cerebellar peduncle.

MRI findings of malignant transformation of epidermoid cyst: case report

Malignant transformation of epidermoid cysts into squamous cell carcinoma (SCC) rarely occurs. A 67-year-old man initially presented with an 8-year history of right trigeminal neuralgia. His symptoms had changed into right facial anesthesia with right-ear hearing impairment 8 months before first consulting a neurosurgeon at our hospital. Results obtained using MRI suggested an epidermoid cyst in the right cerebellopontine angle, but showed atypical findings of a small enhancing nodule in the periphery and surrounding edema in the cerebellum and pons. Surgery was performed to remove the mass, but a small nodule was not reached. Despite stereotactic radiosurgery, the patient's clinical course deteriorated; he died 13 months after the first MRI examination. Autopsy revealed SCC originating from the epidermoid cyst. We present serial MRI and pathologic findings in the early and terminal phases of this patient.