Suprasellar epidermoid cyst in an adult female, presenting as amnesia and somnolence: A rare case report

An unexpected case report of epidermoid cyst at the oculomotor nerve: mimicking a common cyst on MRI

Intracranial epidermoid cysts are benign lesions and are rarely seen in clinical practice. Owing to similarities in imaging findings to those of common cystic lesions, the preoperative diagnosis is rendered challenging. Here, we present a case report of an epidermoid cyst at the right oculomotor nerve, which was initially misdiagnosed as a common cyst. A 14-year-old female child was admitted to our department due to a previous magnetic resonance imaging scan of a cystic lesion on the right side of the saddle that was suspected to be an oculomotor nerve cyst. In our department, this patient underwent a complete surgical resection of the tumor, and the pathology results revealed an epidermoid cyst. This is the first study that reported an epidermoid cyst at the right oculomotor nerve entering the orbit, mimicking a common cyst in imaging. We hope that this study would allow clinicians to consider this type of lesion as a differential diagnosis. Moreover, we suggest that specific diffusion-weighted imaging scan should be performed to aid in the diagnosis.

The Current State of Neurosurgery in Afghanistan

BACKGROUND

Afghanistan has suffered through conflicts that have detrimentally impacted its health care systems. The countries' neurosurgeons have worked through wars and political upheavals to build solid practices and handle large caseloads with minimal supplies and almost no modern tools. Understanding the current state of neurosurgery in Afghanistan and the challenges faced by Afghan physicians and patients is critical to improving the country's healthcare capacity.

METHODS

To assess neurosurgery research in Afghanistan, searches were conducted in databases for articles originating from Afghanistan neurosurgeons and/or neurosurgery departments. We developed a 30-question English-language survey to assess the current state of neurosurgical capacity. Surveys were distributed to neurosurgeons throughout Afghanistan via email with the assistance of our English-speaking Afghan neurosurgical colleagues.

RESULTS

The neurosurgical disease burden of Afghanistan is poorly understood due to the lack of centralized and accessible databases. There are an estimated 124 neurosurgeons in the country based on modeled data. Surveys showed that government hospitals are poorly equipped, with private and military hospitals having access to slightly more modernized equipment but less accessible to the general population. The country lacks neurosurgery research with only 15 papers discovered through database searches deemed relevant to neurosurgery with Afghan affiliations.

CONCLUSIONS

Afghanistan is facing existential humanitarian threats. Developing the country's neurosurgical capacity and general health care capabilities is crucial. Emphasis on training physicians and establishing communication routes, and aid deliverance with the country and its leaders is key to overcoming the many crises it faces.