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Abstract

Epidermoid cysts of the brain (also called intracranial epidermoid cysts or tumors) are benign, rare tumor-like lesions, most often congenital due to maldevelopmental ectodermal inclusion during neural tube closure or acquired (post-surgical or post-traumatic implantation). The incidence is between 1% and 2% of all intracranial tumors, usually located in the parasellar region and cerebellopontine angle. Epidermoid cysts located in the posterior fossa usually arise in the lateral subarachnoid cisterns and those located in the brain stem are rare. They have cheesy and flaky white soft putty like content due to epithelial keratin and cholesterol crystals present. Epidermoid cysts grow very slowly having a similar pattern of the epidermal cells of the skin. Recommended treatment of choice is neurosurgical removal of cystic components with complete resection of capsule. This case is reporting a 34-year-old-man who underwent two neurosurgical procedures for surgical removal of almost silent and giant epidermoid cyst located bilaterally in posterior cranial fossa.