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Epidermoid cysts are rare benign tumors developed from ectodermic inclusions. They usually sit at the ponto-cerebellar angle, the para-sellar region and the temporal fossa. Their seat at the fourth ventricle is unusual. We report two cases of squamous cell cyst in two young patients aged 21 and 33 admitted for intracranial hypertension syndrome associated with walking disorders. The diagnosis of epidermoid cyst of the V4 was evoked on the data of the MRI then confirmed in peroperative and in histology. The surgical excision was subtotal due to adhesion of the capsule to the upper part of the V4 floor. After a 12-month follow-up, the first patient showed no signs of tumor re-evolution. The second patient benefited from a ventriculo-peritonial derivation 45 days after the cyst was removed. After a 7-month follow-up, the patient showed no clinical signs suggestive of tumor re-evolution.

Background: Hydatid cyst (HC) is a parasitic disease caused by Echinococcus granulosus. Involvement of the central nervous system (CNS) is very rare in this parasitic infection and the association of intracerebral and epidural HC is exceptional. Patient and method:A 06-year-old female who was operated three years ago for a left frontal intracerebral hydatid cyst in Toto without rupture and without medical treatment following the surgery, and who came with the history of headache and vomiting for 4 months is reported. Computed tomography of the brain showed a large 5x6x5cm, cystic lesion with a density similar to the cerebrospinal fluid in the left frontal region with another adjacent small cyst in epidural space. The patient underwent left frontal craniotomy. The patient was treated by Dowling technique for intracerebral cyst and by cyst aspiration after rupture. Conclusion:Hydatid cysts in epidural location are very rare and can be primary or after recurrence. The mainstay of treatment is surgical removal of the cyst. Medical therapy is also important to prevent recurrences during the postoperative period.

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