scholarly journals Intracranial Dermoid Cyst in the Posterior Fossa: A Case Report

2021 ◽  
Vol 9 (3) ◽  
pp. 41
Author(s):  
Li Li ◽  
Seidu A. Richard ◽  
Zhigang Lan ◽  
Yuekang Zhang
Keyword(s):  
Dermoid Cyst ◽  
Posterior Fossa ◽  
Cranial Nerves ◽  
Posterior Part ◽  
Hair Follicles ◽  
Auditory Brainstem Responses ◽  
Neurological Deficits ◽  
Sweat Glands ◽  
Total Resection ◽  
First Case

Introduction: Intracranial dermoid cysts are benign, ectopic squamous epithelial cysts often compose of dermal structures like hair follicles, sweat glands as well as sebaceous glands. This lesions constitutes about 0.5% of all intracranial neoplasms. Thus, the occurrence of a dermoid cyst in the posterior fossa is very rare. We report a rare case of intracranial dermoid cyst in posterior cranial fossa. Case Presentation: Our first case was a 32 years old woman who presented with headaches and dizziness with no nausea, vomiting or fever. CT scan revealed a mass at occipital cistern consistent with a cystic lesion. MRI also revealed an irregular lesion in the posterior part of the medulla oblongata with enhanced edges signifying calcifications. We attained total resection of the tumor in a piece meal approach via surgery. Histopathology confirmed dermoid cyst. Two years follow-up revealed no recurrence of the lesion and no neurological deficits. Conclusion: We advocate that, the goal in surgical decision-making should be safe and total resection while monitoring the cranial nerves with electromyographic and auditory brainstem responses.

Microsurgical Resection of Craniocervical Dermoid Cyst by Far Lateral Approach: Case Report and Literature Review

2018 ◽  
Vol 37 (04) ◽  
pp. 339-342
Author(s):  
Lucas Meguins ◽  
Antonio Spotti ◽  
Dionei Morais ◽  
Carlos Rocha ◽  
Ricardo Caramanti ◽  
...  
Keyword(s):  
Case Report ◽  
Dermoid Cyst ◽  
Posterior Fossa ◽  
Symptom Control ◽  
Lateral Approach ◽  
Neurological Deficits ◽  
Uneventful Recovery ◽  
Far Lateral Approach ◽  
Far Lateral ◽  
Posterior Fossa Dermoid

Introduction Intracranial dermoid tumors represent a rare clinical entity that accounts for 0.04 to 0.6% of all intracranial tumors. Their location in the posterior fossa is uncommon. Objectives To report the case of a young woman with a posterior fossa dermoid cyst treated by right far lateral approach. Case Report A 17-year-old woman presenting with swallowing difficulties for 6 weeks was referred for a neurological investigation. A magnetic resonance imaging (MRI) scan showed a hyperintense T1-weighted large expansive lesion occupying the posterior fossa and compressing the anterior face of the brain stem and cerebellum. The patient underwent surgical treatment by right far lateral approach with decompression of vascular and neural structures. The patient presented an uneventful recovery, and was discharged home on the fourth postoperative day without any additional neurological deficits. The anatomopathological analysis confirmed the diagnosis of dermoid cyst. Conclusion The far lateral approach is a safe and feasible route to appropriately treat large posterior fossa dermoid cysts. Decompression of vascular and neural structures is essential to achieve good symptom control.

scholarly journals SURG-08. SUPRASELLAR DERMOID CYST IN A PEDIATRIC PATIENT

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii462-iii462
Author(s):  
Carlos Almeida ◽  
Bruna Minniti Mançano ◽  
Gisele Caravina Almeida ◽  
Gilda D’Agostino Eugui ◽  
Carlos Bezerra Cavalcante
Keyword(s):  
Dermoid Cyst ◽  
Lateral Ventricle ◽  
Brain Magnetic Resonance Imaging ◽  
Radical Resection ◽  
Optic Chiasm ◽  
Hair Follicles ◽  
Sweat Glands ◽  
Subtotal Resection ◽  
High Morbidity ◽  
Left Lateral Ventricle

Abstract BACKGROUND Intracranial dermoid cysts (DC) are rare congenital non-neoplastic lesions that account for 0.04 – 0.6% of all intracranial tumors. They are formed by a fibrous capsule composed of epidermal and dermal derivatives (hair follicles, sebaceous and sweat glands), enclosing a viscous fluid. Intradural DC often arise in the midline and are more common in infratentorial locations. CASE REPORT: A 14-year-old male patient presented with headache, partial motor seizures and behavioral changes. Neurological examination and endocrine workup revealed no abnormalities. Brain magnetic resonance imaging showed a lesion that was 4.4cm x 2.2cm x 4.4cm in size, located at supraselar region, and extended superiorly to the left lateral ventricle and anterolaterally to the left orbitofrontal lobe, associated with hyperintense fat droplets in the right lateral ventricle. We performed a left transventricular microsurgical approach. The tumor capsule was coagulated and opened and a subtotal resection with peacemeal removal of the the lesion was obtained: it had gelatinous consistency, composed of droplets of fat and hair and keratinized scamous epihelium content. A total removal of the DC capsule was not possible due to its firm adherence to optic chiasm and to hypothalamus. Histological examination revealed dermoid cyst. CONCLUSION Surgery is the only effective treatment, and its goal should be the radical resection of the lesion to avoid recurrence. Whenever radical resection is not possible, because of the adhesions of the cyst capsule to surrounding tissues, a subtotal resection with piecemeal removal may be a satisfactory option in such cases to avoid high morbidity.

Partial Transcondylar Approach for Ventral Foramen Magnum Neurenteric Cyst: 2-Dimensional Operative Video

2018 ◽  
Vol 16 (3) ◽  
pp. E81-E81
Author(s):  
Ken Matsushima ◽  
Michihiro Kohno ◽  
Hitoshi Izawa ◽  
Yujiro Tanaka
Keyword(s):  
Cranial Nerves ◽  
Three Dimensional ◽  
Posterior Part ◽  
Foramen Magnum ◽  
Neurological Deficits ◽  
Cystic Tumor ◽  
Occipital Condyle ◽  
Neurenteric Cyst ◽  
Posterior Arch ◽  
Transcondylar Approach

Abstract The anterior foramen magnum area, ventral to the brainstem is one of the most difficult regions to access surgically, and the extent of osseous drilling through the far-lateral or transcondylar approach should be planned in each case based on the tumor extension.1,2 This video, reproduced after informed consent of the patient, demonstrates a case of a ventral foramen magnum neurenteric cyst surgically treated using the partial transcondylar approach. A 27-yr-old woman presented with gait disturbance, oscillopsia, and transient arm numbness. Neuroimaging revealed a ventral foramen magnum cystic tumor involving the basilar and bilateral vertebral arteries. The tumor extended inferiorly from the middle clivus to the C1 level, and occupied the whole premedullary cistern compressing the bilateral lower cranial nerves. The left partial transcondylar approach was performed with drilling the condylar fossa, superior part of the occipital condyle, C1 posterior arch, and posterior part of the jugular process to achieve the sufficient surgical view from the inferolateral side. The drilling of the occipital condyle was minimized so that the articular facet of the occipital condyle was preserved. The tumor on the bilateral side was completely removed as enabled by the sufficient surgical field without new neurological deficits. Three-dimensional reconstructed images based on the postoperative computed tomography scans demonstrated the appropriate extent of the osseous drilling.

Epidermoid cysts of the posterior fossa

1985 ◽  
Vol 62 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Mitchel S. Berger ◽  
Charles B. Wilson
Keyword(s):  
Posterior Fossa ◽  
Cranial Nerves ◽  
Neurological Deficits ◽  
Content Type ◽  
Epidermoid Cysts ◽  
Large Size ◽  
Fourth Decade ◽  
Vascular Structures ◽  
Long Course ◽  
The Brain

✓ Epidermoid cysts originating in the paramedian basal cisterns of the posterior fossa are congenital lesions that grow to a large size through slow accumulation of desquamated epithelium. These lesions grow between and ultimately displace cranial nerves, vascular structures, and the brain stem, causing a long course of progressive neurological deficits. The onset of symptoms usually occurs during the fourth decade of life. Epidermoid cysts are easily diagnosed with computerized tomography scans, which characteristically show a low-density extra-axial pattern. The primary surgical objective is to decompress the mass by evacuating the cyst contents and removing nonadherent portions of the tumor capsule; portions of the capsule adherent to vital structures should be left undisturbed. Aseptic meningitis is the most common cause of postoperative morbidity, and its incidence may be minimized by intraoperative irrigation with steroids followed by systemic therapy with dexamethasone. Symptomatic recurrences that occur many years after surgery should be managed with conservative reoperation.

scholarly journals Retrosigmoid Approach for Resecting a Giant Lateral Pontine Ependymoma: Two-Dimensional Operative Video

2020 ◽  
Author(s):  
Hongxiang Wang ◽  
Yong Yan ◽  
Tao Xu ◽  
Juxiang Chen
Keyword(s):  
Brain Stem ◽  
Posterior Inferior Cerebellar Artery ◽  
Cranial Nerves ◽  
Retrosigmoid Approach ◽  
Gross Total Resection ◽  
Neurological Deficits ◽  
Ependymal Cells ◽  
Total Resection ◽  
Petrosal Vein ◽  
Cerebellar Artery

AbstractEpendymoma is one of the most common pediatric tumors in central nervous system, for which gross total resection has been the most favorable prognostic factor.1 2 However, surgery of ependymomas located in brain stem is significantly challenging. This video demonstrates the microsurgical removal of an ependymoma originating from ependymal cells of the lateral recess of fourth ventricle via retrosigmoid approach in an 11-year-old female. The patient presented with a 6-month history of continues headache and vomiting. On examination, she had a walking instability and an emaciated body. Neuroimaging revealed a right lateral pontine lesion extending to the cerebellopontine angle region. The patient underwent a suboccipital craniotomy, followed by excellent exposure for the tumor. Petrosal vein encased by the tumor mass and close adhesion of the tumor and the initial segments of facial and acoustic nerves adjoined brain stem could be seen operatively. While preserving trigeminal nerve, facial and acoustic nerves, posterior cranial nerves, anterior inferior cerebellar artery, labyrinth artery, posterior inferior cerebellar artery, and petrosal vein, gross total resection was achieved under the careful operation along arachnoid spaces together with intratumoral decompression. The patient tolerated the procedure well without any neurological deficits. Histological examination confirmed the tumor as an ependymoma (WHO II). The cytology measurement of the cerebrospinal fluid did not find any tumor cells. Postoperative computed tomography and magnetic resonance imaging scan depicted complete resection of the tumor, and adjuvant radiotherapy was recommended. She remained symptom-free without any evidence of recurrence during the follow-up period of 1 year. Informed consent was obtained from the patient.The link to the video can be found at: https://youtu.be/sZ9GhUeltwc.

scholarly journals Incomplete Urethral Duplication Associated with a Dermoid Cyst within a Vascular Hamartoma in a Female Dog

2019 ◽  
Vol 6 (2) ◽  
pp. 50 ◽  
Author(s):  
Chad S. Clancy ◽  
Gordon A. Hullinger ◽  
Arnaud J. Van Wettere
Keyword(s):  
Dermoid Cyst ◽  
Hair Follicles ◽  
Sweat Glands ◽  
Pelvic Cavity ◽  
Urethral Duplication ◽  
History Of ◽  
Stratified Squamous Epithelium ◽  
Pelvic Limb ◽  
Collagenous Stroma ◽  
Vascular Hamartoma

A seven-year-old spayed female Labrador retriever presented for necropsy following an acute history of thrombocytopenia, anemia, leukocytosis and abdominal effusion. A 2 × 3 × 10 cm, cylindrical to tubular, mottled red-to-tan mass extended from the caudal pelvic cavity caudally and ventrally under the dermis along the caudal aspect of the left pelvic limb adjacent to the semimembranosus and semitendinosus musculature. Histologic examination of the mass revealed a singular central lumen lined by urothelium that multifocally transitioned into non-keratinizing, stratified squamous epithelium associated with few hair follicles and sweat glands. The lumen was surrounded by a dense collagenous stroma containing numerous, variably sized blood vessels. The combination of lesions was consistent with a diagnosis of incomplete urethral duplication associated with a dermoid cyst and vascular hamartoma. To the authors’ knowledge, this is the first report of an incomplete urethral duplication associated with a dermoid cyst within a vascular hamartoma.

Late postirradiation occlusive vasculopathy in childhood medulloblastoma

1998 ◽  
Vol 89 (3) ◽  
pp. 460-464 ◽  
Author(s):  
Yannick Grenier ◽  
Tadanori Tomita ◽  
MaryAnne H. Marymont ◽  
Sharon Byrd ◽  
Delilah M. Burrowes
Keyword(s):  
Radiation Therapy ◽  
Posterior Fossa ◽  
Arterial Wall ◽  
Posterior Cerebral Artery ◽  
Neurological Deficits ◽  
Content Type ◽  
Psychomotor Delay ◽  
First Case ◽  
Multiagent Chemotherapy ◽  
The Brain

✓ The authors report two cases of ischemic stroke secondary to occlusive vasculopathy two decades after radiation therapy (RT) for medulloblastoma. Both patients underwent posterior fossa medulloblastoma partial resection, followed by craniospinal RT in which a cobalt 60 source was used; 40 Gy were given to the whole brain plus a 15-Gy boost to the posterior fossa. Both patients received multiagent chemotherapy, immediately following radiation therapy in the first case and after repeated craniotomy for recurrence 13 years after radiation in the second case. They experienced multiple sequelae from radiation and chemotherapy, including growth retardation and psychomotor delay. However, 20 years after treatment, they remained tumor free and able to work, until they presented with focal neurological deficits and seizures. Computerized tomography and magnetic resonance imaging of the brain in both cases showed no tumor recurrence, but did demonstrate ischemia in a posterior cerebral artery distribution. Cerebral angiography revealed multiple mid-sized arterial wall irregularities as well as focal stenoses consistent with a postirradiation vasculopathy. The pathophysiological mechanisms, radiological appearance, and incidence of this syndrome are reviewed from the literature.

Recurrence of a neurenteric cyst with malignant transformation in the foramen magnum after total resection

2001 ◽  
Vol 95 (2) ◽  
pp. 341-345 ◽  
Author(s):  
Yoshiyuki Sahara ◽  
Tetsuro Nagasaka ◽  
Masakazu Takayasu ◽  
Teruhide Takagi ◽  
Nobuhiro Hata ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Good Condition ◽  
Cranial Nerves ◽  
Foramen Magnum ◽  
Neurenteric Cyst ◽  
Mr Images ◽  
Total Resection ◽  
Ki 67 ◽  
First Case ◽  
Initial Surgery

✓ A 53-year-old man presented with recurrence of a neurenteric cyst with malignant transformation in the foramen magnum 3.5 years after total resection of the original tumor had been reported. For 2 years following the initial surgery, the patient had been in good condition, but then underwent ventriculoperitoneal shunt placement for intracranial hypertension. At the time there was no evidence of recurrence of the tumor on magnetic resonance (MR) images. One and one-half years later, he presented with headache and anorexia. A massive recurrent tumor was identified on MR images. The tumor was severely adhesive to the brainstem, cranial nerves, and vessels, allowing only partial resection. Histological examination of tumor specimens obtained during the first and second craniotomies indicated a malignant change from a typical neurenteric cyst with a one-layer epithelium in the first specimen to an adenocarcinoma with papillary proliferation in the second. The results of various immunohistochemical studies of the first specimen were typical of those of a neurenteric cyst. The second specimen displayed stronger staining of carbohydrate 19-9 and carcinoembryonic antigens than the initial specimen. The percentage of Ki-67 antigen (MIB-1)—positive cells increased from 0% in the first specimen to 6.7% in the second. To the authors' knowledge this is the first case in which malignant transformation has been demonstrated after total resection of a neurenteric cyst in the foramen magnum.

Medulla oblongata cavernoma removal through a lazy far lateral approach: operative video and technical nuances

2019 ◽  
Vol 1 (2) ◽  
pp. V21
Author(s):  
Carlos Candanedo ◽  
Samuel Moscovici ◽  
Sergey Spektor
Keyword(s):  
Medulla Oblongata ◽  
Cavernous Malformation ◽  
Complete Removal ◽  
Lateral Approach ◽  
Neurological Deficits ◽  
Total Resection ◽  
Postoperative Mri ◽  
Far Lateral Approach ◽  
Far Lateral ◽  
Brainstem Cavernous Malformation

Removal of brainstem cavernous malformation remains a surgical challenge. We present a case of a 63-year-old female who was diagnosed with a large cavernoma located in the medulla oblongata. The patient suffered three episodes of brainstem bleeding resulting in significant neurological deficits (hemiparesis, dysphagia, and dysarthria). It was decided to remove the cavernoma through a left-sided modified far lateral approach.3The operative video demonstrates the surgical steps and nuances of a complete removal of this complex medulla oblongata cavernous malformation. Total resection was achieved without complications. Postoperative MRI revealed no signs of residual cavernoma with clinical improvement.The video can be found here: https://youtu.be/BTtMvvLMOFM.

Fetal pulmonary choristoma: report of first case and literature review

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Anupam Nanda ◽  
Rajinder Nanda ◽  
Seema Thakur ◽  
Tej Prakash Gupta ◽  
Sudhir Jain ◽  
...  
Keyword(s):  
Literature Review ◽  
Exome Sequencing ◽  
Posterior Fossa ◽  
Spinal Column ◽  
Fetal Autopsy ◽  
Case Presentation ◽  
Antenatal Ultrasound ◽  
Clinical Exome Sequencing ◽  
First Case ◽  
Pathologic Findings

AbstractObjectivesLung tissue choristoma is a very rare disorder where mature lung tissues develop in the site not normal to the lung.Case presentationWe hereby report a first case of fetal pulmonary choristoma in a 23–24 weeks fetus where antenatal ultrasound showed a mass in posterior fossa with severe ventriculomegaly. The mass extended inferiorly in cervical spinal column and thereafter extended in the skin over the back of fetus. Fetal autopsy confirmed these findings. Pathologic findings showed mature lung tissues with bronchi, bronchioles, and alveoli. Clinical exome sequencing showed normal results.ConclusionsWe describe the antenatal ultrasound, fetal autopsy and pathologic findings of an intracranial and cutaneous pulmonary choristoma.

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