Giant Intradiploic Epidermoid Cyst in the Occipital Bone: A Case Report

Choo, Yoon-Hee; Seo, Young‐Joon; Choi, Jung-Hwa

doi:10.14791/btrt.2021.9.e3

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…Symptoms typically develop gradually instead of suddenly and depend on the location. Clinical manifestations include local deformities (subcutaneous lump), tenderness, headache, and neurologic symptoms (seizure, focal neurologic deficit, meningitis) [ 5 , 6 ]. Some cases have been reported with intra-orbital expansion causing exophthalmos or diplopia [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…As a result, symptoms usually present gradually due to the local mass effect. It causes a variety of symptoms, such as deformations due to displaced soft tissue, pain, tenderness, focal neurologic deficits, or intracranial hypertension in rare cases [ 1 , 5 , 6 ]. The most common symptom is the local mass effect on soft tissues that causes local deformities [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Tension Pneumocephalus With Acute Cerebellar Symptoms Due to an Intradiploic Epidermoid Cyst Eroding the Mastoid Bone

Schepens,

Van Havenbergh,

Dejaegher

et al. 2024

Cureus

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This case report presents a unique presentation of an intradiploic epidermoid cyst (IDEC) in a 55-year-old female. She presented with acute cerebellar symptoms triggered by a Valsalva maneuver. IDECs are a rare type of intracranial epidermoid cysts. They are benign and have a slow growth pattern that translates into progressively developing symptoms instead of acute symptoms. Symptoms include local deformities, focal neurologic deficits, and pain. This patient developed acute cerebellar symptoms due to erosion of the mastoid bone that created a pathway between the eustachian tube and the intracranial space via the mastoid air cells. Consequently, tension pneumocephalus emerged via a ball-valve effect that caused a significant mass effect in the posterior fossa. Surgical resection of the IDEC and closing of the mastoid air cells resulted in symptom relief by restoring the integrity of the intracranial-extracranial barrier. This case highlights that a higher level of vigilance is warranted for an IDEC in the proximity of aerated bone structures, such as the mastoid air cells and the paranasal sinuses, and that a more proactive approach is advocated.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tension Pneumocephalus With Acute Cerebellar Symptoms Due to an Intradiploic Epidermoid Cyst Eroding the Mastoid Bone

Schepens,

Van Havenbergh,

Dejaegher

et al. 2024

Cureus

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Intradiploic epidermoid cyst in the skull: Case report and systematic review

Errahal,

Baddou,

Leknani

et al. 2025

Radiology Case Reports

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Intradiploic Epidermoid Cyst of the Posterior Fossa – Case Report and Review of the Literature

Januário

Cunha

Cellini

et al. 2022

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Intracranial epidermoid cysts represent ∼ 0.2 to 1.8% of all intracranial tumors. These tumors are most frequently encountered in the cerebellar pontine angle or in the parasellar region. Rarely, they arise from the cranial diploe, being able to affect every flat bone of the cranium.We report a case of a 63-year-old male who presented with progressively worsening headache and vertigo with 6 months of evolution. Neuroimaging identified a probable occipital intradiploic epidermoid cyst with mass effect on the cerebellar hemispheres. This lesion was approached using a suboccipital craniotomy, followed by total resection of the tumor and cranioplasty with titanium plate placement. The histological evaluation confirmed the diagnosis of intraosseous epidermoid cyst. The patient had a successful recovery, without complications or neurologic dysfunction.Being benign lesions, commonly remaining asymptomatic and rarely presenting as a bony lump in the skull bone, it could be straightforward to assume a conservative management with planned follow-up. On the other side, a more aggressive strategy with surgical excision has been advocated, especially in lesions that tend to enlarge and erode the cranial bone with possible consequent epidural extension and mass effect symptoms. A preoperative diagnosis is extremely helpful in proper surgical planning. Diffusion weighted imaging facilitates a straightforward diagnosis.As was observed in our case, the largest reviews on intradiploic epidermoids available in the literature mostly demonstrated a benign clinical course. However, malignant transformation can occur. Some patients develop permanent neurologic deficits from mass effect or tumor infiltration. However, surgical approach of the tumor is curative in most cases. Nonetheless, from our experience, it is important to maintain clinical and imaging follow-up with regular monitoring to prevent possible tumor recurrences.

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Giant Intradiploic Epidermoid Cyst in the Occipital Bone: A Case Report

Cited by 4 publications

References 24 publications

Tension Pneumocephalus With Acute Cerebellar Symptoms Due to an Intradiploic Epidermoid Cyst Eroding the Mastoid Bone

Tension Pneumocephalus With Acute Cerebellar Symptoms Due to an Intradiploic Epidermoid Cyst Eroding the Mastoid Bone

Intradiploic epidermoid cyst in the skull: Case report and systematic review

Intradiploic Epidermoid Cyst of the Posterior Fossa – Case Report and Review of the Literature

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