Ruptured intracranial dermoid cysts: a pictorial review

Jacków-Nowicka, Jagoda; Tse, George; Martin, Andrew; Sąsiadek, Marek; Romanowski, C.A.J.

doi:10.5114/pjr.2018.80206

Cited by 25 publications

(28 citation statements)

References 9 publications

(12 reference statements)

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“…2A1, A2, A3 and A4). These are the typical features described for a dermoid cyst (12). Additionally, our patient had multiple small T1W hyperintensities along subarachanoid spaces and in the left lateral ventricle (Fig.…”

Section: Figuresupporting

confidence: 68%

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Sellar surprises: a single-centre experience of unusual sellar masses

Thakkar¹,

Ramteke-Jadhav²,

Kasaliwal

et al. 2020

Endocrine Connections

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Background Most common incidentally detected sellar-suprasellar region (SSR) masses are pituitary adenomas, followed by craniopharyngioma, rathke’s cleft cyst, hypophysitis, and meningioma. Besides these, certain unusual SSR lesions can sometimes present as diagnostic challenges, where diagnosis is often made post-operatively on histopathology, the pre-operative suspicion of which might have influenced the management strategies. Series describing such masses are few. Objective To present clinical, biochemical, and radiological characteristics and management outcomes of rare SSR lesions other than pituitary adenomas, craniopharyngioma, rathke’s cleft cyst, hypophysitis, and meningioma. Design, setting, patients Retrospective case record analysis of patients with uncommon SSR masses (from January 2006 to December 2016). Results Our series consisted of ten patients, five with neoplastic and five with non-neoplastic lesions. Neoplastic masses included granular cell tumor (n = 2), astrocytoma (n = 1), malignant peripheral nerve sheath tumor (MPNST, n = 1), and metastasis from occult papillary carcinoma of thyroid (n = 1), while non-neoplastic masses were aspergillus abscess (n = 1), sterile abscess (n = 1), and tubercular abscess (n = 1), aneurysm of left internal carotid artery (n = 1), and ruptured dermoid cyst (n = 1). All patients (except one) presented with headache and/or visual disturbance. Only one patient had acromegaly while most others had hypopituitarism. We describe detailed MRI characteristics of each of the lesion. Seven patients underwent trans-sphenoidal surgery. Post-operatively, five patients had permanent diabetes insipidus, while two patients died in early post-operative period. Conclusion Our series expand the differential diagnostic considerations of SSR lesions. Most of the rare SSR masses present with symptoms of mass effects and hypopituitarism. Except for some non-neoplastic lesions like sellar abscesses, aneurysms, and dermoid cysts which can have some specific imaging characteristics that can provide clue to pre-operative diagnosis, most of the other neoplastic masses have overlapping radiological features, and pre-operative suspicion remains difficult.

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Section: Figuresupporting

confidence: 68%

“…2A1 and A3). This feature is considered pathognomonic of rupture of dermoid cyst (12). In case of a ruptured dermoid cyst, treatment of choice remains a surgical exploration and removal of cyst as much as is possible safely, as recurrence or malignant transformation is very uncommon (11).…”

Section: Figurementioning

confidence: 99%

Sellar surprises: a single-centre experience of unusual sellar masses

Thakkar¹,

Ramteke-Jadhav²,

Kasaliwal

et al. 2020

Endocrine Connections

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“…DWI often reveals high signal intensity and indicates the presence of fat components. [11][12][13] The heterogeneity of MRI findings is attributed to variable secretions and desquamations of the cyst, that is, the ratio of cholesterol and keratin in the tumor contents. [11][12][13] In this case, high signal intensity area was seen mixed with a low signal intensity area on T1 weighting.…”

Section: Discussionmentioning

confidence: 99%

A Case of Dermoid Cyst Arising in the Temporal Lobe

Onoda

Kawaguchi

Takaya

et al. 2021

NMC Case Report Journal

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Intracranial dermoid cysts are rare congenital lesions that result from abnormal sequestration of ectodermal cells during neural tube formation. These tumors are especially rare in lateral areas such as in the temporal lobe. In this study, we report a case of dermoid cyst located in the right temporal lobe. A 50-year-old man was referred for further treatment of a tumor. CT revealed a low-density mass lesion in the right temporal lobe, with calcification. MRI showed the lesion with high signal intensity on diffusion-weighted imaging, high-low mixed signal intensity on T1-weighted imaging, and iso-high signal mixed intensity on T2-weighted imaging; the capsule was enhanced with gadolinium. Differential diagnosis included dermoid cyst, epidermoid cyst, teratoma, and neurenteric cyst. We decided to perform surgery for the improvement of his symptom, histopathological diagnosis, and radical cure. A right temporal craniotomy was performed, and the tumor was found adherent to the surrounding brain tissue. The tumor was completely removed under subpial dissection. Hair was confirmed in the tumor content. On histopathology, the cyst wall was lined with stratified squamous epithelium, sebaceous glands, small vessel aggregates, and inflammatory infiltrate. Keratinized material and hair were found in the lumen. The patient was discharged 7 days after surgery with no new neurologic deficits. This case was unusual in terms of the effect of gadolinium enhancement on MRI, and the presence of adipose tissue and calcification were useful for diagnosis. It is vital to consider prevention of chemical meningitis due to intrathecal dissemination of the tumor content intraoperatively.

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“…Congenital dermoid cysts result from trapped epithelial elements when the neural groove closes to form the neural tube, whereas acquired cysts arise from traumatic inclusions of epithelial cells or from the occlusion of the sebaceous gland duct [1 , 3] . Dermoid cysts can remain stable or become symptomatic by enlargement or rupture [4 , 8] . Malignant transformation to squamous cell carcinoma is a rare but a possible complication [9] .…”

Section: Discussionmentioning

confidence: 99%

“…In the fluid-filled center, fatty materials such as liquid cholesterol and degenerated blood components are observed [2] . They are usually diagnosed during infancy or early childhood and are commonly reported in the head and neck region [1 , [3] , [4] , [5] . Dermoid cysts in the subcutaneous layer of the back in adults are difficult to be considered in the differential diagnosis because of its rarity [1 , 6 , 7] .…”

Section: Introductionmentioning

confidence: 99%

Dermoid cyst in the subcutaneous tissues of the back: A rare case with multimodal imaging and pathologic correlation

Chung

Kim

Park

et al. 2021

Radiology Case Reports

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Dermoid cysts are lined by keratinizing squamous epithelium and consist of skin appendages such as hair follicles, apocrine glands, and sebaceous glands. They are usually diagnosed during infancy or early childhood, commonly reported in the head and neck region. A dermoid cyst on the back is extremely rare, with only three cases in the pediatric and adult populations. We report a rare case of a dermoid cyst in the subcutaneous layer of the back in an adult. A 75-year-old man presented with a soft, painless mass on his left upper back. Computed tomography revealed a low-density mass nearly identical to the subcutaneous fat in the subcutaneous layer with nodular soft-tissue density components. It was a heterogeneously hyperechoic mass without internal vascularity on ultrasonography. On magnetic resonance imaging, the lesion showed nearly identical signal intensity (SI) to subcutaneous fat on T1 and T2-weighted images. The soft tissue component was intermediately hyperintense on T1- and T2- weighted images with enhancement. This lesion was pre-operatively suspected as a lipoma variant or a well-differentiated liposarcoma/atypical lipomatous tumor because of the fat density or SI and enhancing portion. We demonstrated and reviewed the multimodality imaging features of dermoid cysts at an unusual location and suggested imaging features that could help readers differentiate dermoid cysts from lipomatous tumors. When a mass shows fat density or SI with or without enhancing soft tissue components at the trunk or extremity, dermoid cysts as well as lipomatous tumors could be considered in the differential diagnosis.

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Ruptured intracranial dermoid cysts: a pictorial review

Cited by 25 publications

References 9 publications

Sellar surprises: a single-centre experience of unusual sellar masses

Sellar surprises: a single-centre experience of unusual sellar masses

A Case of Dermoid Cyst Arising in the Temporal Lobe

Dermoid cyst in the subcutaneous tissues of the back: A rare case with multimodal imaging and pathologic correlation

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