Epidermoid Cyst of the Fourth Ventricle: A Case Report

AbstractEpidermoid cysts constitute congenital, benign and rare lesions, corresponding to ∼ 0.2% to 1.8% of all intracranial tumors. Only 5% of the cases are located in the fourth ventricle. Despite their genesis in intrauterine life, they are usually diagnosed between the third and fifth decades of life due to their very slow growth pattern. The image weighted by the diffusion of the magnetic resonance is essential to establish the diagnosis. The ideal treatment consists of emptying the cystic content with complete capsule resection. In the present work, we report the case of a 31-year-old female with cerebellar syndrome that evolved with intracranial hypertension. The symptomatology was due to an obstructive hydrocephalus by an epidermoid cyst located inside the fourth ventricle, which was confirmed by the pathological anatomy.

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Congenital cholesteatoma of occipital bone or intradiploic epidermoid cyst? One and the same disease

The Journal of Laryngology & Otology ◽

10.1017/s0022215108003083 ◽

2008 ◽

Vol 123 (6) ◽

pp. 673-675 ◽

Cited By ~ 6

Author(s):

M P A Clark ◽

P M Pretorius ◽

D Beaumont ◽

C A Milford

Keyword(s):

Case Report ◽

Middle Ear ◽

Epidermoid Cyst ◽

World Literature ◽

Rare Case ◽

Occipital Bone ◽

Epidermoid Cysts ◽

Congenital Cholesteatoma ◽

Imaging Characteristics ◽

The World

AbstractObjective:We report an extremely rare case of congenital cholesteatoma affecting the occipital bone.Methods:We present a case report, plus a review of the world literature on similar lesions.Results:This case report describes the presentation and treatment of a congenital cholesteatoma arising in an apparently unique location within the occipital bone, with no effect on middle-ear structure or function. The different imaging characteristics of this lesion are described and illustrated. The discussion centres on the differentiation of this lesion from intradiploic epidermoid cysts, more commonly described in the neurosurgical literature. The possible methods of pathogenesis are discussed, along with treatment suggestions.Conclusion:Congenital cholesteatomas and intradiploic epidermoid cysts are indistinguishable both histologically and radiologically, and would appear to be the same disease.

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Conservative management of a fourth ventricular epidermoid in a patient with Gardner syndrome

Therapeutic Advances in Rare Disease ◽

10.1177/2633004020969702 ◽

2020 ◽

Vol 1 ◽

pp. 263300402096970

Author(s):

Gordon D. Heller

Keyword(s):

Case Report ◽

Conservative Management ◽

Epidermoid Cyst ◽

Fourth Ventricle ◽

Resonance Imaging ◽

Gardner Syndrome ◽

Magnetic Resonance Imaging Mri ◽

Intracranial Epidermoid ◽

Brain Cysts ◽

The Brain

Gardner Syndrome is a rare disease with clinical manifestations of familial intestinal polyposis with osteomas. Cutaneous and subcutaneous lesions are common and epidermoid cyst is a characteristic dermatologic finding. This case report presents a novel finding of an intracranial epidermoid situated in the fourth ventricle in a patient with Gardner Syndrome. This intracranial epidermoid has been followed with sequential magnetic resonance imaging (MRI) for 10 years with progressive growth of the lesion. This suggests the conservative management is an option in patients with an enlarging epidermoid cyst in the fourth ventricle. Plain language summary Non-operative treatment of a cyst in the brain in a syndrome called Gardner syndrome. What is Gardner syndrome? Gardner syndrome is a rare disease and form of familial adenomatous polyposis (FAP) that is characterized by multiple small growths of cells (polyps) in the colon and various types of tumors, both noncancerous (benign) and cancerous (malignant). It is caused by changes (mutations) in the APC gene. Abnormal changes on the skin and under the skin are common as well as growths called epidermoid cysts. The cysts develop when cells that are meant to become skin, hair, and nails (epithelial cells) are trapped among the cells that form the brain. Epidermoid brain cysts may be diagnosed by magnetic resonance imaging (MRI) and computerized tomography (CT) scans. Typical treatment usually involves surgery. What was the aim of this case report? To present a different management strategy for patients with Gardner Syndrome with epidermoid brain cysts. How was this patient treated? This patient is the first patient with Gardner Syndrome with a very rare epidermoid brain cyst reported to be treated in a conservative manner. The patient was monitored for 10 years with regular MRI scans and the cyst continued to grow over this time. Despite this growth the patient has shown no signs of a buildup of fluid in the cavities deep within the brain (called hydrocephalus). The patient experienced nonfocal headaches, which were relieved with medication so doctors decided not to surgically remove the cyst. Why is this case important? Conservative management of epidermoid brain cysts in Gardner patients has not been reported before. This case report shows that conservative management may be an alternative option for patients with a growing epidermoid cyst in the fourth ventricle of the brain. Conservative treatment is designed to avoid invasive treatments or surgery and provides a different option for patients who are unable to have surgery.

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Atypical Intracranial Epidermoid Cysts: Rare Anomalies with Unique Radiological Features

Case Reports in Radiology ◽

10.1155/2015/528632 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Eric K. C. Law ◽

Ryan K. L. Lee ◽

Alex W. H. Ng ◽

Deyond Y. W. Siu ◽

Ho-Keung Ng

Keyword(s):

Epidermoid Cyst ◽

Brain Structures ◽

Transverse Sinus ◽

Mri Findings ◽

Epidermoid Cysts ◽

Radiological Features ◽

First Case ◽

Intracranial Epidermoid ◽

Slow Growing ◽

Ct And Mri

Epidermoid cysts are benign slow growing extra-axial tumours that insinuate between brain structures, while their occurrences in intra-axial or intradiploic locations are exceptionally rare. We present the clinical, imaging, and pathological findings in two patients with atypical epidermoid cysts. CT and MRI findings for the first case revealed an intraparenchymal epidermoid cyst that demonstrated no restricted diffusion. The second case demonstrated an aggressive epidermoid cyst that invaded into the intradiploic spaces, transverse sinus, and the calvarium. The timing of ectodermal tissue sequestration during fetal development may account for the occurrence of atypical epidermoid cysts.

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A giant solid cystic inferior fourth ventricle subependymoma – Case report and literature review

Romanian Neurosurgery ◽

10.1515/romneu-2016-0073 ◽

2016 ◽

Vol 30 (4) ◽

pp. 455-460

Author(s):

A. Giovani ◽

Narcisa Bucur ◽

Ana Gheorghiu ◽

Lena Papadopol ◽

R.M. Gorgan

Keyword(s):

Case Report ◽

Literature Review ◽

Posterior Fossa ◽

Fourth Ventricle ◽

Precursor Cells ◽

Benign Tumors ◽

Total Resection ◽

Who Grade ◽

Slow Growing ◽

Glial Precursor

Abstract Subependymomas are a rare subtype of ependymomas, slow growing WHO grade I tumors that develop either intracranial from the subependymal glial precursor cells layer of the ventricles or intramedullary. These tumors originate in the undifferentiated Subependymal layer of cells that can become either ependymocytes or astrocytes. Most of the subependymomas are located inside the fourth ventricle (50-60%). We reviewed the case of a 40 years old woman with a giant solid cystic fourth ventricle ependymoma. The patient underwent total resection of the tumor through a subociipital transvermian approach. We discussed the characteristics of these benign tumors and reviewed the literature on this subject and concluded that total resection is the treatment of choice for symptomatic Subependymomas localized in posterior fossa.

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A rare case of intrathymic epidermoid cyst

Folia Medica ◽

10.3897/folmed.63.e54539 ◽

2021 ◽

Vol 63 (2) ◽

pp. 277-281

Author(s):

Serghei Covantev ◽

Varvara Afanaseva ◽

Alexandru Corlateanu

Keyword(s):

Case Report ◽

Epidermoid Cyst ◽

Rare Case ◽

Anterior Mediastinum ◽

Indication For Surgery ◽

Epidermoid Cysts ◽

Mediastinal Masses ◽

Benign Nature ◽

Thymic Cysts

Thymic cysts are a rare abnormality accounting for 1%–3% of all mediastinal masses. In most cases, they are asymptomatic and localized in the anterior mediastinum. Despite their benign nature, the presence of a mass is an indication for surgery to obtain a histological conclusion and reliably exclude an oncological process. Epidermoid cysts are rare and only a few cases are described in the literature. In our case report, we present a rare case of examination and treatment of a patient with a large anterior mediastinum mass, which, according to the results of histology, was an epidermoid cyst of the thymus.

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Management of Congenital Midline Nasofrontal Masses: Case Report and Review of Literature

Case Reports in Otolaryngology ◽

10.1155/2015/159647 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

A. C. Volck ◽

G. A. Suárez ◽

A. J. Tasman

Keyword(s):

Case Report ◽

Epidermoid Cyst ◽

Fetal Development ◽

Differential Diagnoses ◽

Surgical Approaches ◽

Intracranial Extension ◽

Radiological Imaging ◽

Review Of Literature ◽

Epidermoid Cysts

Epidermoid cysts, dermoids, gliomas, and meningo-/encephaloceles are the most important differential diagnoses in congenital nasofrontal masses. Since they arise from an abnormal fusion during fetal development, intracranial extension of the lesion has to be ruled out radiologically before therapy. Dermoids are the most common entity. We report about a congenital epidermoid cyst of the glabella and nasion that had been growing over the last two years before presentation in a 24-year-old patient. We discuss radiological imaging and the different surgical approaches described in literature.

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Epidermoid cyst traversing the pons into the fourth ventricle. Case report

Surgical Neurology ◽

10.1016/0090-3019(89)90143-2 ◽

1989 ◽

Vol 32 (5) ◽

pp. 377-381 ◽

Cited By ~ 21

Author(s):

Koji Iihara ◽

Haruhiko Kikuchi ◽

Masatsune Ishikawa ◽

Shiro Nagasawa

Keyword(s):

Case Report ◽

Epidermoid Cyst ◽

Fourth Ventricle

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Epidermoid Cyst in the Cerebellopontine Angle: Technical Description Video

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0038-1676997 ◽

2019 ◽

Vol 80 (S 03) ◽

pp. S325-S326

Author(s):

Marcus Vinicius de Morais ◽

Romulo Almino de Alencar Arrais Mota ◽

Thais Aparecida Marques ◽

Rafael Duarte de Souza Loduca ◽

Paulo Mácio de Porto Melo

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Epidermoid Cyst ◽

Cerebellopontine Angle ◽

Transverse Sinus ◽

Skin Incision ◽

Sigmoid Sinus ◽

Neurological Deficits ◽

Safe Procedure ◽

Epidermoid Cysts

Objectives To describe the operative technique for treatment of epidermoid cysts in the cerebellopontine angle (CPA). Design The present video is a case report. Setting Patient is positioned in three-quarters prone. Retrosigmoid approach should be made under neurological monitoring and with neuronavegation to help achieve maximal safe resection. The skin incision is vertical, slightly curved, 5 mm medial to the mastoid notch. Craniectomy is superiorly limited by the transverse sinus and laterally limited by the sigmoid sinus. A C-shaped durotomy is made with its base protecting the sigmoid sinus. The lesion is removed in piecemeal fashion (Fig. 1). The neurological monitoring helps. Results The patient was discharged 2 days later without neurological deficits. Conclusions The surgical treatment associated with neurological monitoring and neuronavegation is a safe procedure to treat epidermoid cysts in the CPA.The link to the video can be found at: https://youtu.be/sEuFyq9c2sw.

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Hemorrhagic Epidermoid Cyst in Cerebellar Vermis: Case Report and Review of the Literature

Journal of Neurological Surgery Reports ◽

10.1055/s-0041-1726286 ◽

2021 ◽

Vol 82 (01) ◽

pp. e6-e10

Author(s):

Ján Kozák ◽

Jozef Šurkala ◽

Martin Novotný ◽

Marián Švajdler

Keyword(s):

Case Report ◽

Epidermoid Cyst ◽

Cerebellopontine Angle ◽

Review Of The Literature ◽

Basal Surface ◽

Parasellar Region ◽

Benign Nature ◽

Intracranial Epidermoid ◽

Slow Growing ◽

The Brain

AbstractIntracranial epidermoid cysts are slow growing congenital avascular neoplasms that spread across the basal surface of the brain. They most commonly occur in the paramedial region in the cerebellopontine angle and the parasellar region. Despite its generally benign nature, sporadically they can be accompanied with hemorrhage or very rarely undergo malignant transformation. The authors present a case report of a patient with a hemorrhagic vermian epidermoid cyst and a review of all published similar cases.

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