Cerebellopontine Angle Epidermoids Presenting with Cranial Nerve Hyperactive Dysfunction: Pathogenesis and Long-term Surgical Results in 30 Patients

Kobata, Hitoshi; Kondo, Akinori; Iwasaki, Koichi

doi:10.1097/00006123-200202000-00008

Cited by 77 publications

(163 citation statements)

References 46 publications

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“…Se presentan a nivel del ángulo pontocerebeloso, de la región paraselar y cuadrigeminal 2,15,21 . También se han descrito casos en otras localizaciones menos frecuentes, como en la Cisura de Silvio, región quiasmática, a nivel ventricular 6 16 .…”

Section: Discussionunclassified

“…Clínicamente se pueden manifestar por alteración de pares craneales 15 o síndrome cerebeloso a nivel infratentorial. Los QE supratentoriales se presentan por cefaleas, crisis comiciales, déficit motores o sensitivos y/o hidrocefalia.…”

Section: Discussionunclassified

“…Es conocido como "el tumor perlado" por sus características macroscópicas de color nacarado. Sus localizaciones más frecuentes son a nivel del ángulo pontocerebeloso, región supraselar y cuadrigeminal 2,15,21 .…”

Section: Introductionunclassified

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Quiste epidermoide intradiploico infratentorial gigante

et al. 2007

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ResumenLos quistes epidermoides son lesiones congénitas benignas, de lento crecimiento, que representan el 1% de todos los tumores intracraneales. En un 25% tienen una localización intradiploica y excepcionalmente infratentorial.Presentamos un caso clínico poco frecuente de un quiste epidermoide intradiploico gigante infratentorial. El paciente consultó por una diplopia y un síndrome cerebeloso. La tomografía computarizada y la resonancia magnética mostraron una lesión gigante lítica extradural de la fosa posterior de 5,2 cm x 3,8 cm, con realce periférico con el contraste. Utilizamos un abordaje suboccipital retrosigmoideo para realizar una exéresis completa tumoral y una resección incompleta capsular, debido a la adherencia de ésta al seno lateral.La evolución posoperatoria fue favorable. Realizamos una revisión bibliográfica de la literatura y discusión de nuestro caso.PALABRAS CLAVE: Quiste epidermoide. Intradiploico. Infratentorial. Giant intradiploic infratentorial epidermoid cyst SummaryEpidermoid cysts are benign, uncommon lesions (1% of all intracranial tumors). Their localization is intradiploic in 25% of cases, and exceptionally subtentorial.We report here a rare case of giant intradiploic infratentorial epidermoid cyst. A 74-year old patient presented with recent diplopia and sindrome cerebellar. CT scan and MR imaging revealed a giant osteolytic extradural lesion of the posterior fossa (5,2 cm x 3,8 cm) with a small area of peripheral enhancement after contrast injection. Retrosigmoid suboccipital craniectomy allowed a satisfactory removal of the tumor, followed by an acrylic cranioplasty. The outcome was good. Neuropathological examination confirmed an epidermoid cyst.We review the literature and discuss our case.KEY WORD: Epidermoid cyst. Intradiploic. Infratentorial. IntroducciónLos quistes epidermoides (QE) intracraneales son lesiones congénitas de bajo grado de crecimiento e histológi camente benignas. Representan alrededor del 1% de todos los tumores intracraneales. Es conocido como "el tumor perlado" por sus características macroscópicas de color nacarado. Sus localizaciones más frecuentes son a nivel del ángulo pontocerebeloso, región supraselar y cuadrigeminal 2,15,21 .Los quistes epidermoides intradiploicos son aproximadamente el 25% de todos los QE 3 . La ubicación en la fosa posterior es poco frecuente.Presentamos el caso clínico de un paciente con diagnós-tico de QE intradiploico infratentorial gigante. Caso clínicoPaciente de 74 años, con antecedentes de miocardiopatía isquémica, que consultó por una diplopia de instalación brusca y un síndrome cerebeloso derecho. En el examen neurológico presentaba una discreta dismetría derecha y una ataxia cerebelosa. El examen oftalmológico fue normal.La tomografía computarizada mostraba una lesión expansiva extradural de la fosa posterior, hipodensa, de 5,2 cm x 3,8 cm, con calcificaciones pericapsulares, con erosión ósea occipital y con realce periférico con el contraste (Fig 1).En la resonancia magnética esta lesión se presentaba

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Quiste epidermoide intradiploico infratentorial gigante

et al. 2007

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“…They include vascular compression, tumors in the CPA, extracranial lesions, and unknown etiology 15,17) . GPN caused by a CPA tumor has been previously reported; however, it is very rare 13,17) . In the report on combined hyperactive dysfunction syndrome of the cranial nerves, Kobata et al 14) reported three cases of epidermoid tumors located in the CPA as a causative factor of the syndrome, but GPN was not present in those cases.…”

Section: A B Cmentioning

confidence: 99%

Glossopharyngeal Neuralgia Caused by Arachnoid Cyst in the Cerebellopontine Angle

Cho

Nam

Park

et al. 2011

J Korean Neurosurg Soc

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“…[2][3][4][5] This study was done to identify and evaluate neurovascular and tumor interrelations in 14 patients with symptomatic (secondary) TN caused by CPA tumors. In this article 10 years of clinical experience in management of patients with TN secondary to CPA tumors is summarized.…”

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Secondary Trigeminal Neuralgia in Cerebellopontine Angle Tumors

Shulev¹,

Gordienko²,

Trashin³

2011

Skull Base

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The analysis of the treatment results in patients with cerebellopontine angle (CPA) tumors, manifested as trigeminal neuralgia (TN). During the 10-year period from 1998 to 2008, 14 patients with verified CPA tumors that had the typical manifestations of TN were operated on at our hospital (5.8% from all patients with TN who underwent surgery). In nine cases the epidermoid was identified; three patients had meningioma, one patient had acoustic neurinoma, and one patient had lipoma. The follow-up of all patients lasted at least 12 months. The intraoperative assessment identified the three variants of relationship between the tumors and neurovascular structures: (1) tumor grows around the trigeminal nerve; (2) the tumor causes compression and displacement of the trigeminal nerve; and (3) tumor presses the arterial vessel to the trigeminal nerve by moving the vessel or nerve. For six patients, with removal of tumor a microvascular decompression of the trigeminal nerve was performed. Complete pain relief was achieved in 12 patients (86%). TN is an expectative symptom of CPA tumors. The most frequent cause of secondary TN of CPA tumors is epidermoid. All patients with manifestations of TN should undergo the magnetic resonance imaging for early diagnosis of CPA tumor.

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Cerebellopontine Angle Epidermoids Presenting with Cranial Nerve Hyperactive Dysfunction: Pathogenesis and Long-term Surgical Results in 30 Patients

Cited by 77 publications

References 46 publications

Quiste epidermoide intradiploico infratentorial gigante

Quiste epidermoide intradiploico infratentorial gigante

Glossopharyngeal Neuralgia Caused by Arachnoid Cyst in the Cerebellopontine Angle

Secondary Trigeminal Neuralgia in Cerebellopontine Angle Tumors

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