Epidermoid cyst in Anterior, Middle & Extension of Posterior cranial fossa: rare Imaging with review of literature

Abstract Epidermoid cysts are benign slow growing more often extra-axial tumors that insinuate between brain structures, we present the clinical, imaging, and pathological findings in 35 years old female patients with atypical epidermoid cysts which was situated anterior, middle & posterior cranial fossa. NCCT head revealed hypodense lesion over right temporal and perisylvian region with extension in prepontine cistern with mass effect & midline shift and MRI findings revealed a non-enhancing heterogeneous signal intensity cystic lesion in right frontal & temporal region extending into prepontine cistern with restricted diffusion. Patient was detoriated in night of same day of admission, emergency Fronto-temporal craniotomy with anterior peterousectomy and subtotal resection was done. The histological examination confirms the epidermoid cyst. The timing of ectodermal tissue sequestration during fetal development may account for the occurrence of atypical epidermoid cysts.

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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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Clinical, surgical and postoperative outcome analysis of tumors occupying both posterior and middle cranial fossa

Nepal Journal of Neuroscience ◽

10.3126/njn.v18i2.33783 ◽

2021 ◽

Vol 18 (2) ◽

pp. 36-44

Author(s):

Rahul Singh ◽

Ravi Shankar Prasad ◽

Ramit Chandra Singh ◽

Kulwant Singh ◽

Anurag Sahu

Keyword(s):

Postoperative Outcome ◽

Middle Cranial Fossa ◽

Posterior Cranial Fossa ◽

Gross Total Resection ◽

Outcome Analysis ◽

Subtotal Resection ◽

Combined Approach ◽

Total Resection ◽

Trigeminal Schwannoma ◽

Cranial Fossa

Objectives: To analyse clinical, surgical and postoperative outcome perspectives of tumors occupying both middle and posterior cranial fossa. Materials and Methods: This retrospective cohort study includes 23 patients operated for tumors involving both middle and posterior cranial fossa in our department between August 2016 and August 2020. Each patient was evaluated for age, sex, co morbidities, tumour histopathology, clinical presentation, radiological characteristics, surgical and outcome characteristics. Unpaired t- test and chi-square test was used for statistical analysis. P < 0.05 was considered statistically significant. Results: The mean age was 46 years (range 40–57 years), with the majority of patients being female (56.5%). Most tumors (65.3%) were trigeminal schwannoma, with the remaining being vestibular schwannoma (21.7%), facial schwannoma (8.7%) and epidermoid (4.3%). The most commonly used surgical approach was the retrosigmoid approach (30.4%) and combined approach (30.4%). Gross total resection (GTR) was done in 14 patients while subtotal resection (STR) was done in 9 patients. STR was significantly associated (p<0.05) with persisting cranial nerve deficit and tumour progression. Midbrain compression, internal carotid artery and cavernous sinus involvement were significantly (p<0.05) associated with STR. Conclusions: Trigeminal schwannoma is the most common tumour involving both middle and posterior cranial fossa. Combined approach for such tumours is required in tumours having significant size in both middle cranial fossa and posterior cranial fossa. The intent of surgery is to achieve a gross total resection (GTR) but adhesions and involvement of critical brain structures results in STR.

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A rare epidermoid cyst occurring in an young female: a case report and literature review

10.21203/rs.2.22806/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Roxana Dumitriu ◽

Roxana Dușceac ◽

Anda Dumitrașcu ◽

Cătălina Poiană

Keyword(s):

Diabetes Insipidus ◽

Epidermoid Cyst ◽

Cushing Syndrome ◽

Residual Tumor ◽

Brain Structures ◽

Pituitary Hormones ◽

Young Female ◽

High Rate ◽

Epidermoid Cysts ◽

Subarachnoid Spaces

Abstract Background Epidermoid cysts are very rare benign lesions of epithelial origin, slow growing extra-axial tumours and they accord for 1% of all intracranial tumours. They frequently occur at the cerebellopontine angle and parasellar regions insinuating brain structures. They are often associated with a high rate of residual tumor and recurrence. Clinical Case We present the case of a 18 year old patient who was admitted in the our clinic for secondary amenorrhea. The CT scan showed a large median mass with a mixed structure (calcareous and cystic) resembling a craniopharyngioma. Preoperatively the hormonal profile showed deficiency of all anterior pituitary hormones. Transsphenoidal surgery was performed and the histopathological exam established the diagnosis of sellar epidermoid cyst with parasellar extension. Postoperatively the patient developed iatrogenic Cushing syndrome (due to large amounts of dexamethasone given) and diabetes insipidus. Conclusion Epidermoid cysts are challenging tumours because of the extension along the subarachnoid spaces around delicate neurovascular structures therefore they are difficult to be completely resected. The particularity of this case stands in the rare occurrence of this types of tumours and the fact that although in these patients with hypopituitarism diabetes insipidus is present primarily our patient developed postoperatively.

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Ependymomas of the posterior cranial fossa: CT and MRI findings

Neuroradiology ◽

10.1007/bf01578265 ◽

1995 ◽

Vol 37 (3) ◽

pp. 238-243 ◽

Cited By ~ 30

Author(s):

P. Tortori-Donati ◽

M. P. Fondelli ◽

A. Cama ◽

M. L. Garrè ◽

A. Rossi ◽

...

Keyword(s):

Posterior Cranial Fossa ◽

Mri Findings ◽

Cranial Fossa ◽

Ct And Mri

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Chronic Lyme Disease with an Expansive Granulomatous Lesion in the Cerebellopontine Angle

Neurosurgery ◽

10.1227/00006123-199009000-00018 ◽

1990 ◽

Vol 27 (3) ◽

pp. 446-451 ◽

Cited By ~ 10

Author(s):

Michael Mokry ◽

Gerhard Flaschka ◽

Gertrude Kleinert ◽

Reinhold Kleinert ◽

Franz Fazekas ◽

...

Keyword(s):

Lyme Disease ◽

Cerebellopontine Angle ◽

Surgical Intervention ◽

Chronic Phase ◽

Posterior Cranial Fossa ◽

Subtotal Resection ◽

Cerebral Lesion ◽

Chronic Lyme Disease ◽

Granulomatous Lesions ◽

Cranial Fossa

Abstract Expansive granulomatous lesions in the posterior cranial fossa are rare and have not been reported in conjunction with Lyme disease. We report a patient with verified Borrelia burgdorferi infection who developed a tumor in the cerebellopontine angle. Rapid growth of the tumor led to signs of cerebral compression and to hydrocephalus. Surgical intervention was required despite florid meningitis. The histological examination showed inflammatory, nonspecific granulation tissue. The origin of this tissue is almost certainly causally related to the B. burgdorferi infection. Signs of inflammation resolved rapidly after subtotal resection. The clinical, radiological, and biochemical course is documented. This is the first report of an expansive cerebral lesion in the chronic phase of Lyme disease.

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Dermoid and epidermoid cysts of the midline in the posterior cranial fossa

Neurosurgical Review ◽

10.1007/bf00345926 ◽

1992 ◽

Vol 15 (3) ◽

pp. 171-175 ◽

Cited By ~ 13

Author(s):

P. Lunardi ◽

P. Missori ◽

F. M. Gagliardi ◽

A. Fortuna

Keyword(s):

Posterior Cranial Fossa ◽

Epidermoid Cysts ◽

Cranial Fossa

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SURGICAL TREATMENT OF CEREBELLAR SCHISTOSOMIASIS

Neurosurgery ◽

10.1227/01.neu.0000344000.79237.88 ◽

2009 ◽

Vol 64 (5) ◽

pp. 941-944 ◽

Cited By ~ 11

Author(s):

Kai Shu ◽

Suojun Zhang ◽

Lin Han ◽

Ting Lei

Keyword(s):

Surgical Treatment ◽

Intracranial Pressure ◽

Mass Effect ◽

Posterior Cranial Fossa ◽

Increased Intracranial Pressure ◽

Therapeutic Measures ◽

Cranial Fossa ◽

Pathological Focus

Abstract OBJECTIVE To explore the surgical treatment of cerebellar schistosomiasis. METHODS Twelve cases of cerebellar schistosomiasis treated in our department were analyzed retrospectively. RESULTS All cases were cured. At the 2-year follow-up examination, all patients could perform physical tasks normally. CONCLUSION Cerebellar schistosomiasis tends to cause mass effect of the posterior cranial fossa and increased intracranial pressure. Microresection of the pathological focus and decompression of the posterior cranial fossa should be effective therapeutic measures.

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Combined endoscopic endonasal transtubercular and transclival approaches for large neurenteric cyst in posterior cranial fossa: A case report and literature review

Surgical Neurology International ◽

10.25259/sni_648_2021 ◽

2021 ◽

Vol 12 ◽

pp. 554

Author(s):

Daisuke Sato ◽

Hirotaka Hasegawa ◽

Masahiro Shin ◽

Kenji Kondo ◽

Nobuhito Saito

Keyword(s):

Posterior Fossa ◽

Skull Base Surgery ◽

Abducens Nerve ◽

Posterior Cranial Fossa ◽

Neurenteric Cyst ◽

Endoscopic Endonasal ◽

Prepontine Cistern ◽

Suprasellar Region ◽

Transnasal Surgery ◽

Cranial Fossa

Background: Intracranial neurenteric cysts (NCs) are extremely rare tumors that more commonly involve the posterior fossa than any other cranial part. While transcranial skull base surgery has been the mainstay of treatment, the utility of endoscopic transnasal surgery (ETS) remains to be established. Case Description: We report a case of a large posterior fossa NC extensively involving the suprasellar region, cerebellopontine angle, and prepontine cistern, which we successfully resected with ETS through a combination of transtubercular and transclival routes. Before surgery, the patient presented with abducens nerve and pseudobulbar palsies, which resolved within 2 weeks postoperatively. The patient remained free from recurrence for 3 years postoperatively. Conclusion: Extended ETS may offer a minimally invasive option for the posterior fossa NC, extensively occupying the ventral space of the brainstem.

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