An Intracranial Extradural Dermoid Cyst Presenting with Two Dermal Sinuses and an Abscess in a Child

Abstract

Dermoid cysts account for only a small fraction of intracranial masses, with extradural dermoid cysts being considered a much rarer entity than those located intradurally. Intracranial dermoid cysts vary in clinical presentations: some maybe asymptomatic whilst others harbor features of raised intracranial pressure, neurological deficits, or even aseptic meningitis. Dermoid cysts may also present with cutaneous lesions. Herein, we report a rare case of a 1-year-old female presenting with a midline, scalp abscess. Brain MRI revealed an intracranial, extradural tumor, with features suggestive of a dermoid cyst, unusually located in the crista galli, and complicated by the formation of two cutaneous sinus tracts. After identification and characterization by MRI, bitemporal craniotomy was performed with complete excision of the mass and sinus tracts. Histological analysis confirmed dermoid cyst as the final diagnosis. Postoperatively, the patient recovered fully and had no evidence of recurrence in subsequent visits. The case mentioned above highlights the rarity of such a presentation for an intracranial extradural dermoid cyst and the vitality of early imaging for midline cutaneous lesions for identification of intracranial extensions and avoidance of detrimental consequences.

Intracranial Interdural and Extradural Cerebellar Convexity Dermoid Cyst: A Case Report of Rare Tumor at the Rarest Location

“…6 Traumatic implantation has also been an alternate hypothesis in the genesis of dermoids. 5 Lateral extradural dermoids have been postulated to develop from dural multipotent embryonic cells or from translocation of the epithelial cells of developing neovasculature. 7 These rare tumors account for 0.04 to 0.7% of all intracranial lesions.…”

“…Rupture may lead to severe aseptic meningitis, ventriculitis, and death. 5 MRI of the cranium is the investigation of choice. Dermoids show variable relaxation time depending upon fat content.…”

Dermoid Cyst in the Posterior Fossa Associated With Dermal Sinus and Abscess Formation: A Case Report

“…Therefore, dermoid cysts tend to appear along the midline, which corresponds to the sites of embryonic fusion. On the other hand, cysts can also develop at any age due to traumatic implantation, which involves the movement of skin elements from the surface to the underlying tissue [ 2 , 11 ].…”

Growing Pains: A Rare Case of a Temporal Dermoid Cyst in an Adult and Review of the Literature

“…Literature supports that dermoid cysts originate from multipotent embryonic stem cells or from translocated epithelial cells that migrated from the optic vesicles or developing neurovasculature. 8 Histopathological examination is characterized by stratified squamous epithelium with mature skin appendages found on their walls and within their lumens, which are often filled with keratin and hair. 7 While dermoid cysts are considered to be congenital, only 40% are diagnosed at birth, and 60% are diagnosed by 5 years of age.…”