Intradiploic epidermoid cysts of the skull: Report of 10 cases and review of the literature

Abstract

Intradiploic epidermoid cysts, fairly uncommon lesions in neurosurgical practice, are, as a rule, benign and slow-growing. Some attain great size, producing major neurological signs. Correct radiological assessment and complete removal of the tumour and its capsule are essential for adequate surgical treatment and good long-term prognosis. We report ten cases of intradiploic epidermoid cysts of the skull, three of which were giant lesions and one malignant, and analyze the clinicopathological and radiological features and treatment of these lesions in the light of the most important published data.

Posttraumatic Giant Extradural Intradiploic Epidermoid Cysts of Posterior Cranial Fossa : Case Report and Review of the Literature

“…In correspondence with that the age at the onset of complaints in this group (mean age of 55 years, range-24-74 years) was logically higher compared with that of the non-giant intradiploic epidermoid cysts of the skull (mean age of 32 to 38 years) 3) . An utter male sex predilection was outlined in the current series (male : female ratio-8 : 0) in contrast to the data of other reviews of intradiploic epidermoid cysts of the skull 3,6) . The duration of symptoms on admission in the studied group was short and range between 1 and 5 months (mean 3 months), which is most likely explained .…”

“…The presence of painful or painless subcutaneous swelling was not a compulsory, but extremely indicative feature of the diagnosis infratentorial giant intradiploic extradural epidermoid cyst 3,6) . Neurological examination was non-uniformly positive depending on the predominant direction of the tumor growth-intra-or extracranial and the grade of the occipital bone destruction.…”

“…The first primary intradiploic epidermoid cyst was reported by Müller in 1838 8) . Ciappetta et al 3) cited a total of 223 cases of intradiploic extradural epidermoids, reported in the literature by 1990. Some of these epidermoid cysts may attain giant size before they are diagnosed.…”

A swelling on the fore head- the tip of the iceberg

“…The cyst lining can be very adherent to the brain structures hence a complete cyst removal may not be possible in many patients. 9 If any of the cyst wall was not removed, they can continue to enlarge slowly and recur after surgery hence follow-up MRIs is necessary for many years to monitor for recurrence. Chemotherapy and radiotherapy are generally not used for treating epidermoid cysts.…”

Dumbbell-Shaped Intradiploic Epidermoid Cyst Involving the Dura Mater and Cerebellum -Case Report-

“…2,6,12,15) Intracranial epidermoid cysts are usually located in the cerebellopontine angle and parasellar region, as well as the petrous apex, chiasmal region, brain stem, or intraventricular cavity. 5,7) About 25% of central nervous system epidermoid cysts are intradiploic, [1][2][3][4][5]9,10,12,13) and about 3% of intradiploic epidermoid cysts extend to the subdural space.…”