2021JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCHOpen access

Intracranial Dermoid and Epidermoid Cysts: A Case Report

Anmol Taneja, Samarth Shukla, Sourya Acharya, Sunita Vagha

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Abstract

Dermoid and epidermoid cysts are ectodermally derived neuraxis cysts, both lined by keratinising squamous epithelium. Epidermoid cyst is filled by friable, often lamellated keratinous debris and is devoid of cutaneous-type adnexal structures, as found in dermoid cysts. They are usually located at the cerebellopontine angle, cerebellar vermis, fourth ventricle, parasellar region, and frontal and fronto-temporal cisternal spaces but the cerebellopontine angle being their single most common location of epidermoid cysts whereas dermoid cyst clings tightly to the midline. Hereby, the authors are presenting a case report of two cases; first case is of a one-month-old child presented with 4×4 cm sized cystic swelling over occipital region since birth with redness since 15 days with complaint of pus discharge from the swelling since one day. Cyst with contents was sent for histopathological examination and features suggestive of intracranial dermoid cyst. Second case is of 14-year-old female child who presented with the complaints of headache since six months and imbalance since two months. Magnetic Resonance Imaging (MRI) was suggestive of cerebellopontine angle tumour with hydrocephalus. Tumour was excised and sent for histopathological examination and features suggested of epidermoid cyst. These benign lesions are potentially curable. As these cases were suspected as malignant tumours but as they found out to be diagnosed as benign lesions. Although these lesions are benign but can still lead to some seroius complications. We are reporting these cases for its early diagnosis and thereby better management.

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What this paper is about

Dermoid and epidermoid cysts are ectodermally derived neuraxis cysts, both lined by keratinising squamous epithelium. Epidermoid cyst is filled by friable, often lamellated keratinous debris and is devoid of cutaneous-type adnexal structures, as found in dermoid cysts. They are usually located at the cerebellopontine angle, cerebellar vermis, fourth ventricle, parasellar region, and frontal and fronto-temporal cisternal spaces but the cerebellopontine angle being their single most common location of epidermoid cysts whereas dermoid cyst clings tightly to the midline. Hereby, the authors are presenting a case report of two cases; first case is of a one-month-old child presented with 4×4 cm sized cystic swelling over occipital region since birth with redness since 15 days with complaint of pus discharge from the swelling since one day. Cyst with contents was sent for histopathological examination and features suggestive of intracranial dermoid cyst. Second case is of 14-year-old female child who presented with the complaints of headache since six months and imbalance since two months. Magnetic Resonance Imaging (MRI) was suggestive of cerebellopontine angle tumour with hydrocephalus. Tumour was excised and sent for histopathological examination and features suggested of epidermoid cyst. These benign lesions are potentially curable. As these cases were suspected as malignant tumours but as they found out to be diagnosed as benign lesions. Although these lesions are benign but can still lead to some seroius complications. We are reporting these cases for its early diagnosis and thereby better management.

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Available abstract

Dermoid and epidermoid cysts are ectodermally derived neuraxis cysts, both lined by keratinising squamous epithelium. Epidermoid cyst is filled by friable, often lamellated keratinous debris and is devoid of cutaneous-type adnexal structures, as found in dermoid cysts. They are usually located at the cerebellopontine angle, cerebellar vermis, fourth ventricle, parasellar region, and frontal and fronto-temporal cisternal spaces but the cerebellopontine angle being their single most common location of epidermoid cysts whereas dermoid cyst clings tightly to the midline. Hereby, the authors are presenting a case report of two cases; first case is of a one-month-old child presented with 4×4 cm sized cystic swelling over occipital region since birth with redness since 15 days with complaint of pus discharge from the swelling since one day. Cyst with contents was sent for histopathological examination and features suggestive of intracranial dermoid cyst. Second case is of 14-year-old female child who presented with the complaints of headache since six months and imbalance since two months. Magnetic Resonance Imaging (MRI) was suggestive of cerebellopontine angle tumour with hydrocephalus. Tumour was excised and sent for histopathological examination and features suggested of epidermoid cyst. These benign lesions are potentially curable. As these cases were suspected as malignant tumours but as they found out to be diagnosed as benign lesions. Although these lesions are benign but can still lead to some seroius complications. We are reporting these cases for its early diagnosis and thereby better management.

Key concepts: Epidermoid cyst, Cerebellopontine angle, Dermoid cyst, Medicine, Magnetic resonance imaging, Cyst, Anatomy, Radiology

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