Epidermoid tumors of the IV ventricle: Report of 3 cases

Bini, Walter; Sepehrnia, Abolghassem; Dundar, Mehmet Sait; Samii, Madjid

doi:10.1016/s1130-1473(93)70848-9

Cited by 3 publications

(10 citation statements)

References 33 publications

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“…[ 3 4 5 6 ] They arise as epithelial sequestrations during the 3 rd to 5 th week of development and persist after neural tube closure. [ 7 8 ] Their growth rate is linear to that of the epidermis. [ 9 ] They become symptomatic, usually in the second to fourth decades of life.…”

Section: Introductionmentioning

confidence: 99%

“…[ 5 6 10 ] Tumor grows due to the accumulation of desquamated cells and their breakdown products such as keratin and cholesterol. [ 7 ] Unlike dermoid cyst, they are located off-midline. They are also more common than dermoid cysts.…”

Section: Introductionmentioning

confidence: 99%

“…They are also more common than dermoid cysts. [ 7 ] About half of these intracranial lesions occur in the cerebellopontine angle. [ 3 6 11 ] Epidermoid cysts are the third most common lesion in this location after vestibular schwannomas and meningiomas.…”

Section: Introductionmentioning

confidence: 99%

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Fourth ventricular epidermoid cyst – Case series, systematic review and analysis

et al. 2021

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Background: Epidermoid cysts are extra-axial, pearly white avascular lesions mostly found in the cerebellopontine region. They are slow-growing and mostly become symptomatic when they attain significant size. They do occur at other anatomical locations, but fourth ventricle is a rare location. Three representative cases with their outcomes are described here. Methods: The systematic review was done with adherence to predefined criteria. The studied variables were age, gender, duration of symptoms (DOS), clinical features, hydrocephalus (HCP), extent of resection, postoperative complications, outcome, follow–up, and recurrence. Statistical analysis was done to identify predictive factors for outcome. Results: Final analysis included 58 studies containing 131 patients. The most common clinical feature was cerebellar dysfunction (93%). The most common cranial nerve involved was the abducens nerve ( n = 37, 28.46%). Preoperative HCP was present in nearly a third (35%) of patients. The outcomes were not different with age ( P = 0.23), gender ( P = 0.74), DOS ( P = 0.09), and HCP ( P = 0.50). Improved outcomes were associated with total resections ( P = 0.001), absence of preoperative cranial nerve dysfunctions ( P = 0.004), and presentation with features of raised intracranial pressure ( P = 0.005). Longer DOS (mean 76.74 months) was associated with significantly increased cranial nerve nuclei involvement ( P = 0.03). Aseptic meningitis was reported in 14.5% of cases. Recurrences were infrequently reported ( n = 9). Conclusions: Although the fourth ventricular epidermoid lesions are difficult to detect in an innocuous stage, when found, they should be extirpated early and totally, as a longer DOS leads to cranial nerve dysfunctions and suboptimal outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fourth ventricular epidermoid cyst – Case series, systematic review and analysis

et al. 2021

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“…9,10 The surgical excision is based on the intracapsular debulking and extracapsular dissection. 11 However, two complications may alter the course of the disease: aseptic meningitis and malignant transformation. 9 Aseptic meningitis is the main influencing factor of postoperative course.…”

Section: Discussionmentioning

confidence: 99%

“…4 The surgical approach must be carefully performed, and based on a combination of symptoms and radiological data, considering the slow rate of residual tumor growth. 11 The literature indicates that adjuvant therapy for epidermoid cysts is scarce and, according to some authors, nonexistent. 17 However, Parikh et al reported a case of success in inhibiting recurrence of a benign intracranial epidermoid cyst with the use of radiation during two years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Epidermoid Cyst Located in the Fourth Ventricle: Case Report and Review

2016

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Posterior Fossa Midline Epidermoid Tumors: Role of the Inferior Medullary Velum and a Proposed New Imaging Classification

et al. 2023

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BACKGROUND: Posterior fossa midline epidermoid tumors (PFMETs) include the epidermoid tumors of the cisterna magna (CM) and fourth ventricle (FV). OBJECTIVE: To report tumor epicenter-based classification of PFMETs and its clinical and surgical implications with outcome. METHODS: On retrospective analysis of operated cases of intracranial epidermoid tumors, 19 (N = 19) patients having tumor epicenter within FV, CM, or both were included. Cerebellopontine and prepontine cistern epidermoid were excluded. Tumor location was decided based on preoperative MRI and intraoperative findings. Major complication was defined as new onset or worsening of cranial nerve (CN) deficit, sensory motor impairment, or tracheostomy. RESULTS: The mean (±SD) age of the patients was 42.0 ± 11.6 years (range 25-61 years), with no sex predilection (male: female: 1:0.9). The most common symptoms were cerebellar dysfunction, headache, vomiting, and diplopia. Common CNs affected were VII, V, lower cranial nerve, and VI. The PFMETs were classified based on tumor epicenter as type 1 (tumor epicenter in CM, n = 4/21.1%), type 2 (FV, n = 5/26.3%), and type 3 (involved CM and FV, n = 10/52.6%). Type 2 tumors had a higher incidence of raised intracranial pressure and only facial nerve palsy as preoperative CN deficit. Type 1 tumors had the least incidence of postoperative major complications. Type 3 tumors were the largest and had a greater incidence of brainstem adhesion and postoperative complications. The tumor size, duration of symptoms, and patient age were higher in patients with brainstem adhesion (5.3 ± 1.0 cm, 21 ± 16 months, 44.1 ± 9.2 years) as against its absence (4.8 ± 1.3 cm, 11.2 ± 7.3 months, 38.2 ± 11.7 years). Inferior medullary velum and tela choroidea have a critical role in tumorogenesis, tumor extension, and brainstem adhesion. CONCLUSION: PFMETs can be classified into 3 subtypes based on tumor epicenter having clinical and surgical implications. Less aggressive dissection and near total excision in the presence of brainstem adhesion yield favorable outcomes.

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Epidermoid tumors of the IV ventricle: Report of 3 cases

Cited by 3 publications

References 33 publications

Fourth ventricular epidermoid cyst – Case series, systematic review and analysis

Fourth ventricular epidermoid cyst – Case series, systematic review and analysis

Epidermoid Cyst Located in the Fourth Ventricle: Case Report and Review

Posterior Fossa Midline Epidermoid Tumors: Role of the Inferior Medullary Velum and a Proposed New Imaging Classification

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