Hemorrhagic epidermoid cyst in a patient with generalized tonic clonic seizure

Singh, Navneet; Symons, Sean; Montanera, Walter; Kaderali, Zul; Müller, Paul J.; Muñoz, David G.; Marotta, Thomas R.

doi:10.1016/j.jocn.2012.03.051

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…The etiological mechanism behind hemorrhage into RCCs is obscure, but usually there is no identified antecedent traumatic or other inciting event. Also of note is the fact that, since the time of Paulus et al , numerous parallel examples of hemorrhage into other types of benign cysts such as arachnoid cysts , colloid cysts or even epidermoid or developmental cysts have been reported. Some of these bleeds have been linked to trauma, but many have been spontaneous events.…”

Section: Introductionmentioning

confidence: 99%

Review of xanthomatous lesions of the sella

Kleinschmidt‐DeMasters

Lillehei

Hankinson

2017

Brain Pathology

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Xanthomatous lesions of the sellar region have traditionally been divided into two separate categories, xanthomatous hypophysitis (XH) and xanthogranuloma (XG) of the sellar region. The seminal article on XH, a condition typified by foamy histiocytes and lymphoplasmacytic infiltrates in the pituitary gland/sellar region, but usually little or no hemosiderin pigment, detailed three patients. However, most reports since that time have been single cases, making understanding of the entity difficult. In contrast, the seminal report on XG, characterized by sellar region cholesterol clefts, lymphoplasmacytic infiltrates, marked hemosiderin deposits, fibrosis, multinucleated giant cells around cholesterol clefts, eosinophilic granular necrotic debris, and accumulation of macrophages, included 37 patients, allowing more insights into etiology. Few examples could be linked to adamantinomatous craniopharyngioma, and although ciliated epithelium similar to that of Rathke cleft cyst (RCC) was identified up to 35% of the 37 cases, it could not be proven that XG was related to hemorrhage into RCC. Case reports since that time, however, occasionally linked XG to RCC when an etiology could be identified at all, and a few recognized that a spectrum exists in xanthomatous lesions of the sella. They review literature, adding 23 cases from our own experience, to confirm that overlap occurs between XH and XG, and that the majority-but not all-can be linked to RCC leakage/rupture/hemorrhage. It was suggested that progressive accumulation of hemosiderin pigment in the lesion, possibly caused by the multiple episodes of bleeding, could account for the transition of at least some cases of XH to XG.

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Section: Introductionmentioning

confidence: 99%

Review of xanthomatous lesions of the sella

Kleinschmidt‐DeMasters

Lillehei

Hankinson

2017

Brain Pathology

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“…Moreover, various authors reported hyperdensity of intracranial EC, caused by high-concentrated protein content of the cyst. 3,4,6,13 In the series by Li et al, hyperdense EC represented 3% of all cases. The authors assumed that recurrent leakage of the cyst contents and a subsequent chemical inflammatory response may be responsible for the high density of some EC on CT. 4 Likewise, causes of atypical signal changes present on MRI, except of hemorrhage, include calcification and increased protein concentration as a result of inflammation or infection.…”

Section: Discussionmentioning

confidence: 93%

“…Intracranial ECs, also known as pearly tumors are congenital avascular intracranial neoplasms that account for approximately 1.5% of all intracranial tumors and 7 to 9% of all cerebellopontine angle tumors. [1][2][3][4] ECs are thought to result from aberrantly located ectodermal cells, that have been entrapped during the process of neurulation in the period between the third and fifth gestational weeks. Typical slow and linear rate of growth of EC is caused by accumulation of desquamated keratin, cellular debris, and cholesterol crystals.…”

Section: Discussionmentioning

confidence: 99%

“…On MRI ECs usually present as hypointense and hyperintense on T1 and T2-weighted images, respectively without contrast enhancement due to the absence of a well-developed vascular network, 1,2,5,7,8 although minor rim enhancement has been reported. 3 Diffusion-weighted imaging shows intense signal as a result of restriction of water movement and this diffusion restriction differentiates EC from other cystic lesions. 8 Intra-operatively ECs are typically well-defined lesions with an irregular nodular outer surface and a shiny mother of pearl appearance.…”

Section: Discussionmentioning

confidence: 99%

“…7 Due to avascular nature of EC, intralesional hemorrhage is extremely rare and has only been reported a few times. [3][4][5][6][7][9][10][11] In our literature review, we found five cases of vermian hemorrhagic EC with our case to be the sixth (►Table 1).…”

Section: Discussionmentioning

confidence: 99%

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Hemorrhagic Epidermoid Cyst in Cerebellar Vermis: Case Report and Review of the Literature

Kozák

Novotný

et al. 2021

J Neurol Surg Rep

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Intracranial epidermoid cysts are slow growing congenital avascular neoplasms that spread across the basal surface of the brain. They most commonly occur in the paramedial region in the cerebellopontine angle and the parasellar region. Despite its generally benign nature, sporadically they can be accompanied with hemorrhage or very rarely undergo malignant transformation. The authors present a case report of a patient with a hemorrhagic vermian epidermoid cyst and a review of all published similar cases.

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