Unusual coexistence of an epidermoid cyst with an atypical meningioma: Case report and review of the literature

Abstract

Background:Coexistence of multiple primary intracranial tumors of different cell types has rarely been documented; the association of a meningioma and a glioma has been reported as the most common combination. Hereby, we report an unusual case of a temporal epidermoid cyst coexisting with an atypical meningioma.Case Presentation:A 37-year-old male presented with progressive symptoms of raised intracranial progression with progressive loss of vision without any neurological deficit. On admission, magnetic resonance imaging (MRI) revealed a right frontal lesion appearing hypointense T1, hyperintense T2 slightly enhanced after gadolinium and a second right temporal, isointense T1, hyperintense T2 non-enhancing lesion. A right frontotemporal craniotomy was performed that revealed two distinct lesions: The whitish temporal lesion with the pearl appearance reminding of an epidermoid cyst, the second lesion was extraaxial fibrous lesion arising from the falx. Pathology confirmed an atypical meningioma WHO Grade II and an epidermoid cyst.Conclusion:The simultaneous occurrence of primary intracranial tumors of different cell types is rare. Epidermoid cysts are slow growing lesions believed to arise from inclusion of ectodermal elements during neural tube closure, while meningiomas arise from arachnoidal cells; their association has rarely been reported previously.

Co-existing Tumors On Suprasellar Region : A Rare Case and Review of Literature

“…Thomalske and Galow were reported meningioma and cerebellopontine angle epidermoid cyst in 1975 5 . In 1979, Frazer and Victoratos 6 reported a co-existing epidermoid cyst and meningioma developed after cranial radiotherapy Karekezi et al reported a patient with right frontal lobe meningioma and right temporal lobe epidermoid cyst in 2016 7 . While the anatomical location of both tumors is different in most cases of meningiomas and epidermoid cysts reported in the literature, Kumar et al reported the association of meningioma and epidermoid cyst located in the same localization 8 .…”

“…Epidermoid cysts are tumors of embryological origin, and studies on whether they affect the development of meningioma are limited. Karekezi et al stated that according to their theory, the cerebrospinal fluid (CSF) circulating around and under the arachnoid membrane of the epidermoid cyst might be an effective factor in the development of meningioma by stimulating tumor cell growth through irrigation of neighboring regions 7 . It has been suggested that meningiomas secrete EGF and EGF secretion, and local paracrine stimulation may play a role in the development of epidermoid cysts 11 .…”

Collision tumor of squamous cell carcinoma of the scalp and meningioma: A case report

“…Multiple primary intracranial tumors of different cell types were observed only in patients with neurofibromatosis type 2, a finding that is rare in other patients. The most common comorbidity of various types of cancer is meningioma with glioma [6] . When performing the differential diagnosis of rapidly growing skull lesions, it is important to be aware of impingement tumors to ensure optimal treatment.…”