Dermoid and Epidermoid Tumors (Cholesteatomas) of Central Nervous System

Love, J. Grafton

doi:10.1001/jama.1936.02770490030009

Cited by 120 publications

(36 citation statements)

References 3 publications

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“…All of our poor surgical outcomes, including the one postoperative death, were pre-sumably caused by injury to basal cistern vascular elements with secondary infarction. The symptomatic recurrence rate of 26% for intradural lesions in our series is comparable to that of other series 1~ 16,26,36 Only one of the five patients who underwent reoperation for recurrence had an increase in neurologic deficit postoperatively. These excellent results after re-operation for recurrence have also been reported by other groups 36.…”

Section: Discussionsupporting

confidence: 83%

Craniocerebral epidermoid and dermoid tumours: a review of 32 cases

et al. 1994

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We reviewed 22 epidermoid and 10 dermoid tumours of the skull and brain from patients operated on consecutively at Henry Ford Hospital between 1975 and 1991. There were 19 intradural (16 epidermoid, 3 dermoid) and 13 extradural (6 epidermoid, 7 dermoid) lesions. The average age at presentation was 35 years for patients with epidermoids and 15 years for those with dermoids. Common clinical presentations for patients with intradural lesions included headache, visual deficits, and seizures, whereas patients with extradural lesions harbored asymptomatic scalp masses. All patients with intradural lesions were investigated with computed tomography (CT) and cerebral angiography, and 8 patients underwent magnetic resonance imaging (MRI). Total resection was possible in 12 (92%) of 13 extradural tumours, all with excellent outcomes. Eight (42%) of the intradural tumours were completely resected. Overall, with the intradural tumours we had good to excellent results in 17 patients (90%), poor results in 1 (5%), and 1 death (5%). Re-operation was needed in 5 intradural recurrences (26%) with deterioration in only one patient's neurologic status postoperatively. From a review of ours and others' data, we conclude that 1) these tumours have an insidious onset despite significant size and mass effect as demonstrated by imaging studies; 2) CT, angiography, and particularly MRI help to define the extent of subarachnoid tumour spread and involvement of neurovascular structures, thus permitting better surgical planning; 3) a significant number of intradural tumours are difficult to excise because of their adherence to neurovascular structures, and thus are related to higher morbidity and mortality; and 4) because of extremely slow growth, complete tumour resection should not be the goal at the risk of injury to neurovascular structures.

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Section: Discussionsupporting

confidence: 83%

Craniocerebral epidermoid and dermoid tumours: a review of 32 cases

et al. 1994

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“…As a result, there is subsequent inclusion of epiblasts in the neural tube. 4,12,14 These tumors grow very slowly via progressive accumulation of normally dividing cells (epidermal cells). 4,12 As a result, they can often reach a large size before the onset of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…4,12,14 These tumors grow very slowly via progressive accumulation of normally dividing cells (epidermal cells). 4,12 As a result, they can often reach a large size before the onset of symptoms. 16,17 Epidermoid lesions possess specific imaging characteristics, and resemble other lesions of the brain on MR images, including arachnoid cysts on certain sequences.…”

Section: Discussionmentioning

confidence: 99%

Neurosurgical management of intracranial epidermoid tumors in children

Ibrahim

Auguste²,

Vachhrajani³

et al. 2009

PED

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Object Epidermoid tumors are benign lesions representing 1% of all intracranial tumors. There have been few pediatric series of intracranial epidermoid tumors reported previously. The authors present their experience in the management of these lesions. Methods The neurosurgical database at the Hospital for Sick Children was searched for children with surgically managed intracranial epidermoid tumors. The patients' charts were reviewed for demographic data, details of clinical presentation, surgical therapy, and follow-up. Ethics board approval was obtained for this study. Results Seven children, all girls, were identified who met the inclusion criteria between 1980 and 2007. The average age at surgery was 11.2 years (range 8–15 years), and the mean maximal tumor diameter was 2.1 cm. Headache was the most common presenting symptom, and 1 tumor was found incidentally. Most patients had normal neurological examinations, but meningism was found in 2 cases. There were 3 cerebellopontine angle lesions, 1 pontomedullary lesion, and 3 supratentorial tumors. Hydrocephalus developed in 1 patient after aseptic meningitis, and she underwent shunt placement. There were no operative deaths. Complete resection could be performed in 2 patients. One patient experienced a small recurrence that did not require a repeated operation, while 1 subtotally resected lesion recurred and the patient underwent a second operation. Conclusions Intracranial epidermoid tumors are rare in the pediatric population. Total resection is desirable to minimize the risk of postoperative aseptic meningitis, hydrocephalus, and tumor recurrence. Aggressive neurosurgical resection may be associated with cranial nerve or ischemic deficits, however. In these cases, neurosurgical judgment at the time of surgery is warranted to ensure maximum resection while minimizing postoperative neurological deficits.

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“…They result from incomplete cleavage of the neural ectoderm from cutaneous ectoderm. The resultant of epiblasts in the neural tube may slowly grow with accumulation of normally dividing cells (1,2). They may reach a large size gradually before onset of symptoms (4,5).…”

Section: Discussionmentioning

confidence: 99%

Giant intramedullary epidermoid extending from brain stem to upper thoracic spinal cord.

Kansal

Mahore²,

Dange³

2010

Turkish Neurosurgery

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Epidermoid cysts are benign tumors originating from ectoderm remnants. Most epidermoid cyst cases are intracranial. Spinal epidermoid cysts are uncommon and most of the reported cases are in the thoracic and lumbar spine. Occurrence of intramedullary epidermoid cysts in the cervical spine is extremely rare. An 18-year-old male with a giant intramedullary tumor extending from the brain stem to the upper thoracic spinal cord presented at our outpatient department. The patient underwent total excision of a silvery white lesion through a midline myelotomy. Histopathological examination was suggestive of an epidermoid cyst. We present a brief report of the case and discuss the relevant literature. KeywoRds: Epidermoid, Intramedullary, Spinal cord ÖZEpidermoid kistler ektoderm kalıntılarından gelişen benign tümörlerdir. Çoğu epidermoid kist vakası intrakraniyaldir. Spinal epidermoid kistler nadirdir ve bu vakaların çoğu torasik ve lumber omurgada bildirilmiştir. Servikal omurgada intramedüller epidermoid kistlerin oluşması çok nadirdir. Beyin kökünden üst torasik spinal korda kadar uzanan dev bir intramedüller tümörü bulunan 18 yaşında bir erkek hasta polikliniğimize başvurdu. Hastada bir orta hat myelotomisi yoluyla gümüş renginde beyaz lezyonun total eksizyonu yapıldı. Histopatolojik inceleme epidermoid kist düşündürdü. Vakanın kısa bir sunumunu yapıyor ve ilgili literatürü gözden geçiriyoruz.

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Dermoid and Epidermoid Tumors (Cholesteatomas) of Central Nervous System

Cited by 120 publications

References 3 publications

Craniocerebral epidermoid and dermoid tumours: a review of 32 cases

Craniocerebral epidermoid and dermoid tumours: a review of 32 cases

Neurosurgical management of intracranial epidermoid tumors in children

Giant intramedullary epidermoid extending from brain stem to upper thoracic spinal cord.

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