Ruptured Intracranial Dermoid Cyst Presenting With Neuropsychiatric Symptoms: A Case Report

Abstract

Psychiatric symptoms associated with frontal lobe unruptured or ruptured intracranial dermoid cysts are rarely described in the medical literature. The case of a 58-year-old man with a chronic history of anxiety, major depression, and obsessive compulsive disorder who presented with new onset auditory and visual phenomena is described. This case illustrates the need to include an underlying brain tumor in the differential diagnosis when encountering new onset auditory and visual phenomena in patients with chronic mood and/or anxiety disorders.

A young woman with progressive headache after head trauma

“…1,2 The most common location of dermoid tumors is the midline, in contrast to epidermoids. The posterior fossa, parasellar and frontobasal regions are common locations for dermoid tumors.…”

“…3 Dermoid tumor rupture is rare, and although rupture usually occurs spontaneously, rupture following closed head trauma has rarely been reported. [1][2][3] The presenting symptoms of a ruptured dermoid tumor include headache, visual disturbance (as a result of compression of visual pathways by tumors), seizures, and aseptic meningitis due to fat droplets in the subarachnoid space or ventricular system. 2,3 A CT scan has limited utility in the differential diagnosis due to difficulties differentiating fat droplets from pneumocephalus; therefore, MRI is an important tool for diagnosis.…”

Intra-axial CNS dermoid cyst

“…[7] These tumors present with headache, seizures, neurological deficits and aseptic meningitis, and ventriculitis, if rupture occurs. [78] Radiological diagnosis at times is difficult unless fat particles and calcification can be demonstrated. [9] Intraoperative diagnosis is the only sure means of detecting a dermoid, after careful examination of the contents, though newer imaging techniques like use of fat suppression images may help in making an accurate diagnosis, preoperatively.…”

Primer Bir Psikiyatrik Bozukluğu Taklit Eden Spontan Rüptüre İntrakraniyal Dermoid Kist

“…Intracranial dermoid cysts (IDC) are benign, rare, slow growing lesions and they arise from inclusion of ectodermally committed cells at the time of closure of the neural groove between the third and fifth week of embryonic life, thus usually located along the midline (1). Various clinical aspects, such as presentation with increased intracranial pressure, hydrocephalus, epileptic seizures, aseptic meningitis (Mollaret's meningitis), focal neurological deficits, and also rarely neurobehavioral symptoms have been reported (2,3,4). A 14-year-old male patient presented with acuteonset neuropsychiatric symptoms for two months.…”