Epithelial (Epidermoid) Tumors of the Cranium

Toglia, Joseph U.; Netsky, Martin G.; Alexander, Eben

doi:10.3171/jns.1965.23.4.0384

Cited by 160 publications

(54 citation statements)

References 16 publications

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“…[9][10][11][12] The incidence of dermoid cysts is markedly higher than epidermoid cysts over the anterior fontanelle. 10,13) We have experienced no epidermoid cyst at this location. This situation can be explained by the different embryological origin of dermoid and epidermoid cysts.…”

Section: Discussionmentioning

confidence: 99%

Congenital Dermoid Cyst of the Anterior Fontanelle in Turkish Children-Four Case Reports-

Aslan¹,

Ozveren

Kotıl

et al. 2004

Neurol. Med. Chir.(Tokyo)

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Section: Discussionmentioning

confidence: 99%

Congenital Dermoid Cyst of the Anterior Fontanelle in Turkish Children-Four Case Reports-

Aslan¹,

Ozveren

Kotıl

et al. 2004

Neurol. Med. Chir.(Tokyo)

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“…5 Justifying the practice of subtotal removal and conservative handling of the capsule, 7,44,46,57 this hypothesis assumes that as little as a single cell remains postoperatively and that the recurring mass grows at the same rate as the original tumor. 44 Multiple investigators suggest that the actual proliferation of this epithelium beyond the normal remnant should be considered a neoplasm, 51,53 even with an incidence of malignant progression; hence, they should be treated the same as other benign tumors for which surgical removal is the goal. Echoing other authors, 19,24 Altschuler and associates 4 stated that repeated surgical attempts on these tumors are difficult and fraught with neurological complications for the patient.…”

Section: Neuroimagingmentioning

confidence: 99%

“…Regardless of the argument that the capsule is a mere remnant of epithelium, some epidermoids grow faster than natural epithelium and enlarge or recur through cellular proliferation, and thus act as a true benign neoplasm 53 and even occasionally a malignant one 1,11,27,36,37,47,53 with leptomeningeal metastasis from the intracranial malignant transformation of an epidermoid tumor. 25,33 Furthermore, malignant conversion has been reported as the recurrence of a previously benign epidermoid.…”

mentioning

confidence: 99%

“…25,33 Furthermore, malignant conversion has been reported as the recurrence of a previously benign epidermoid. 21,53,54 Several investigators have commented that since the capsule is the "living portion" of the tumor," 8,12,34 recurrence is inevitable with a residual capsule. Total removal of the capsule, which is now possible with microsurgical techniques, can prevent recurrence, and if only a minute portion of the capsule is overlooked during surgery, recurrence may at least be long delayed.…”

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confidence: 99%

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Giant intracranial epidermoids: is total removal feasible?

Aboud¹,

Abolfotoh

Pravdenkova³

et al. 2015

JNS

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OBJECT Epidermoid tumors arise from misplaced squamous epithelium and enlarge through the accumulation of desquamated cell debris. Optimal treatment consists of total removal of the capsule; therefore, giant and multicompartmental tumors are particularly challenging. A conservative attitude in handling the tumor capsule is common given concerns about capsule adherence to neurovascular structures, and thus the possibility of recurrence is accepted with the intent of minimizing complications. This study focuses on the outcome of surgery in patients with giant epidermoid tumors for which total capsule removal was the aim. METHODS The authors conducted a retrospective analysis of all patients with giant epidermoid tumors treated by the senior author (O.A.), who pursued total removal of the capsule through skull base approaches. Patients were divided into 2 groups: one including patients with de novo tumors and the other consisting of patients who presented with recurrent tumors. RESULTS Thirty-four patients had undergone 46 operations, and the senior author performed 38 of these operations in the study period. The average tumor dimensions were 55 × 36 mm, and 25 tumors had multicompartmental extensions. Total removal of the tumor and capsule was achieved with the aid of the microscope in 73% of the 26 de novo cases but in only 17% of the 12 recurrent tumor cases. The average follow-up among all patients was 111 months (range 10–480 months), and the average postsurgical follow-up was 56.8 months (range 6–137 months). There were 4 recurrences in the de novo group, and every case had had a small piece of tumor capsule left behind. One patient died after delayed rupture of a pseudoaneurysm. In the de novo group, the average preoperative Karnofsky Performance Scale (KPS) score was 71.42%, which improved to 87.14% on long-term follow-up. In the group with recurrences, the KPS score also improved on long-term follow-up, from 64.54% to 84.54%. In the de novo group, 3 cases (11.5%) had permanent cranial nerve deficits, and 4 cases (15.4%) had a CSF leak. In the recurrence group, 3 cases (25%) had new, permanent cranial nerve deficits, and 1 (8.3%) had a CSF leak. Two patients in this group developed hydrocephalus and required a shunt. CONCLUSIONS Total removal of the capsule of giant epidermoid tumors was achieved in 73% of patients with de novo tumors and was associated with improved function, low morbidity and mortality, and a lower risk of recurrence. Surgery in patients with recurrent tumors was associated with higher morbidity and persistence of the disease.

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“…1,21) Epidermoid tumors of the fourth ventricle account for between 5% and 31.4% of all intracranial epidermoid tumors. 7,9,13,15,16,19,20) The clinical symptoms vary depending on the location, extension, and degree of adhesion to vital structures.…”

Section: Introductionmentioning

confidence: 99%

Reversible Bilateral Vestibular Impairment Caused by Fourth Ventricle Epidermoid Tumor-Case Report-

Kambe

Anno

Oda

et al. 2003

Neurol. Med. Chir.(Tokyo)

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A 26-year-old man presented with an epidermoid tumor of the fourth ventricle manifesting as headache with nausea and vertigo. Neurological examination revealed no cerebellar signs, except nystagmus. Bilateral vestibular impairment was identified by the caloric test. The tumor was removed via the midline suboccipital approach. The bilateral peripheral vestibular function recovered remarkably postoperatively. This marked improvement suggests that the bilateral vestibular impairment was caused by compression of the vestibular nuclei by the tumor.

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Epithelial (Epidermoid) Tumors of the Cranium

Cited by 160 publications

References 16 publications

Congenital Dermoid Cyst of the Anterior Fontanelle in Turkish Children-Four Case Reports-

Congenital Dermoid Cyst of the Anterior Fontanelle in Turkish Children-Four Case Reports-

Giant intracranial epidermoids: is total removal feasible?

Reversible Bilateral Vestibular Impairment Caused by Fourth Ventricle Epidermoid Tumor-Case Report-

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