Intracranial Epidermoid Tumor After Subcutaneous Lipoma Excision  -Case Report-

Kato, Koichi; Higa, Takashi; Ujiié, Hiroshi; Chernov, Mikhail; Kubo, Osami; Hori, Tomokatsu

doi:10.2176/nmc.48.262

Cited by 4 publications

(2 citation statements)

References 15 publications

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“…8,14,[19][20][21][22][23][24] In a landmark review, Lepoire and Pertuiset 25 offered an ingenious explanation regarding the seemingly haphazard anatomic distribution of the intradural tumors, considering that the epiblastic inclusions are carried to their final destinations by the developing network of cerebral arteries. However, epidermoids are often seen in several other intracranial compartments such as the interhemispheric fissure, and intraventricular and even intradiploic locations.…”

Section: Embryogenesis and Pathologymentioning

confidence: 99%

Supratentorial Epidermoid Tumors

Kesavapisharady

Menon

Kumar

et al. 2012

Neurosurgery Quarterly

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Epidermoid tumors form nearly 1% of spinal neoplasms and 0.2% to 1.8% of intracranial neoplasms. Intracranial epidermoids are most often located in the cerebellopontine angle, and supratentorial locations are relatively rare. We reviewed our singleinstitution experience of having treated 32 patients with supratentorial epidermoid tumors with an intention to contribute to the general body of knowledge of these tumors. The clinical profile, imaging characteristics, management options, and long-term outcomes were analyzed retrospectively and compared with the available literature. Supratentorial epidermoids commonly present with seizures closely followed by headache. Diffusion-weighted imaging magnetic resonance imaging is an important imaging tool both in the diagnosis and in the early detection of recurrences. Attempts at total excision can result in serious complications, especially in areas where the capsule is densely adherent to major neurovascular structures. The long-term functional outcome is not influenced by the extent of excision. Surgery should therefore aim at providing maximum tumor clearance without producing any new deficits. E pidermoid tumors belong to the spectrum of "tumors of disordered embryogenesis" and are known to occur at diverse locations in the neuraxis. These "congenital epithelial lesions" reported initially by Love and Kernohan 1 in 1936 form nearly 1% of spinal neoplasms and 0.2% to 1.8% of intracranial neoplasms. Intracranial epidermoids are most often located in the cerebellopontine angle, and supratentorial locations are relatively rare.We reviewed our single-institution experience of having treated 32 patients with supratentorial epidermoid tumors with an intention to contribute to the general body of knowledge of these tumors. The clinical profile, imaging characteristics, management options, and longterm outcomes were analyzed retrospectively and compared with the available literature.

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Section: Embryogenesis and Pathologymentioning

confidence: 99%

Supratentorial Epidermoid Tumors

Kesavapisharady

Menon

Kumar

et al. 2012

Neurosurgery Quarterly

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“…Epidermoid cysts are benign lesions and constitute 0.2% to 1.8% of brain tumors with preponderance in the cerebellopontine (CP) angle cistern followed by the parasellar region . They can present with symptoms ranging from compression of local structures to mass effect and CSF flow obstruction.…”

Section: Introductionmentioning

confidence: 99%

Fulminant leptomeningeal carcinomatosis from a malignant melanoma arising in a cerebellopontine epidermoid cyst: A rare case with diagnostic pointers

et al. 2018

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A malignant component in an epidermoid cyst is rare. We report an exceptionally rare case of a malignant melanoma arising in an epidermoid cyst located in the cerebellopontine (CP) angle. A 26-year-old woman presented with headache, vomiting, ataxia and difficulty in swallowing over the previous 3 months. The radiological finding suggested an epidermoid cyst and the lesion was excised. The histopathology confirmed a CP angle epidermoid cyst. Within 1 month of discharge, she developed hydrocephalus for which a ventriculo-peritoneal shunt was performed. Postoperatively she developed weakness in lower limbs. A contrast-enhanced MRI was done which showed dilated CSF cisternal spaces with a small enhancing lesion in the pineal region and enhancement of meninges extending to the spinal cord. Re-exploration showed gelatinous material with gross adhesions in the CP angle cistern. A dural biopsy was done which showed sheets of poorly differentiated tumor cells which expressed S100 and Melan A and were immunoreactive with Human Melanoma Black (HMB)-45 antibody, consistent with the diagnosis of malignant melanoma. Histology of the excised epidermoid cyst was re-evaluated in deeper sections and showed scattered atypical melanocytes in the basal layer of the epidermis which were highlighted with HMB-45 antibody. The patient expired within 3 days of the second procedure due to respiratory failure. A very aggressive fulminant course of the disease was evident after surgery for the epidermoid cyst. Treatment options are limited. Criteria for identification of malignancy in an intracranial epidermoid cyst were identified in our case retrospectively and have been highlighted.

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