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Shaikh MY, Sharif S, Rafay M. Primary Intracranial Squamous Cell Carcinoma Arising in Dermoid Cyst. Asian J Neurosurg 2019; 14:904-906. [PMID: 31497125 PMCID: PMC6703049 DOI: 10.4103/ajns.ajns_200_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Primary intracranial squamous cell carcinoma represents a rare entity. However, few cases have been reported in the literature so far. We report the case of a 32-year-old male who presented with a history of severe headache and vertigo for 3 weeks. Magnetic resonance imaging brain with contrast was done that showed a lesion measuring 5 cm × 4.8 cm in the left cerebellum near the midline which was hyperintense on T2 and hypointense on T1. It also showed ring-like heterogeneous contrast enhancement causing midline shift as well as pressure over the brainstem causing severe obstructive hydrocephalus. After emergency ventriculoperitoneal shunt placement, the patient subsequently underwent left paramedian suboccipital craniotomy and excision of space-occupying lesion. Intraoperatively, a well-demarcated capsule was identified. The entire lesion consisting of areas of calcification and hair particles was removed except the part of capsule which was adherent to the brainstem. Histopathology of the lesion showed infiltrating malignant neoplasm exhibiting papillary architecture with thick fibrovascular cores lined by stratified squamous cells. In order to rule out the possibility of metastases, systemic workup was done which yielded negative results.
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Affiliation(s)
| | - Salman Sharif
- Department of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan
| | - Muhammad Rafay
- Department of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan
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Chung LK, Lagman C, Duong C, Nagasawa DT, Tucker AM, Yong WH, Yang I. Dermoid Cyst of the Prepontine Cistern and Meckel's Cave: Illustrative Case and Systematic Review. J Neurol Surg B Skull Base 2017; 79:139-150. [PMID: 29868318 DOI: 10.1055/s-0037-1604332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/10/2017] [Indexed: 10/19/2022] Open
Abstract
Objective Dermoid cysts are benign, congenital malformations that account for ∼0.5% of intracranial neoplasms. The authors describe a 42-year-old female with a prepontine dermoid cyst who underwent apparent gross total resection (GTR) but experienced cyst recurrence. To date, very few cases of prepontine dermoid cysts have been reported. The prevalent region where these cysts are located can be difficult to determine. In addition, the authors systematically review the literature to characterize the clinical presentation, anatomical distribution, and surgical outcomes of intracranial dermoid cysts. Design Systematic review. Setting/Participants PubMed, Web of Science, and Scopus databases. Main Outcome Measures Extent of resection, symptom improvement, and recurrence rates. Results A total of 69 patients with intracranial dermoid cysts were identified. Three (4.3%) intracranial dermoid cysts were located in the prepontine cistern. The average age of patients was 33.3 years. The most common presenting symptoms were headache (52.2%) and visual disturbances (33.3%). Intracranial dermoid cysts were distributed similarly throughout the anterior, middle, and posterior cranial fossae (29.0%, 36.2%, and 29.0%, respectively). GTR was achieved in 42.0% of cases. Thirty-four (49.3%) patients experienced symptom resolution. Recurrence rate was 5.8% at a mean follow-up of 2.1 years. Conclusions Intracranial dermoid cysts most often present as headaches and visual disturbances. Intracranial dermoid cysts were found in the anterior, middle, and posterior cranial fossae at similar frequencies but with clear predilections for the Sylvian fissure, sellar region, and cerebellar vermis. Outcomes following surgical excision of intracranial dermoid cysts are generally favorable despite moderate rates of GTR.
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Affiliation(s)
- Lawrance K Chung
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - Carlito Lagman
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - Courtney Duong
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - Daniel T Nagasawa
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - Alexander M Tucker
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - William H Yong
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - Isaac Yang
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States.,Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States.,Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
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Garces J, Mathkour M, Beard B, Sulaiman OAR, Ware ML. Insular and Sylvian Fissure Dermoid Cyst with Giant Cell Reactivity: Case Report and Review of Literature. World Neurosurg 2016; 93:491.e1-5. [PMID: 27237420 DOI: 10.1016/j.wneu.2016.05.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 05/15/2016] [Accepted: 05/17/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Dermoid cysts are rare intracranial tumors that are most commonly found infratentorially and along the midline. Characterized by slow growth and often found incidentally, these lesions can nonetheless have severe complications, notably rupture leading to chemical meningitis. They infrequently present as a supratentorial and lateralized mass. As such, sylvian fissure dermoid cysts are exquisitely rare. We present a rare case of a dermoid cyst with giant cell reactivity suggestive of focal rupture and chronic inflammation. CASE DESCRIPTION A 61-year-old female presented with new-onset seizures. Magnetic resonance imaging revealed a right insular mass measuring 4.3 × 4.5 cm with compression of the ipsilateral frontal and temporal lobes. The mass was nonenhancing; however, it was bright on diffusion-weighted imaging, suggesting a dermoid cyst. She underwent craniotomy for tumor resection. Histologic analysis revealed keratinizing squamous epithelium, sebaceous glands, and hair follicles associated with giant cell reaction involving the capsule of the cyst consisted with dermoid cyst. At 2.5 years post operation, she is seizure free and without evidence of recurrence. CONCLUSION The dermoid cyst in our patient was not grossly ruptured, but histopathologic analysis revealed giant cell reactivity, which may indicate focal rupture or chronic inflammation. The relationship between rupture of dermoid cysts and inflammation is not well elucidated. It is not known whether symptoms occur immediately after rupture or as an acute manifestation of a chronic process following rupture. As these lesions are quite rare and rupture is even rarer, more diligence on our part regarding details of histopathology for dermoid cysts is necessary.
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Affiliation(s)
- Juanita Garces
- Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Mansour Mathkour
- Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Division of Neurosurgery, Department of Surgery, Jazan University, Jazan, Saudi Arabia.
| | - Bryce Beard
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | | | - Marcus L Ware
- Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
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Jacquin A, Béjot Y, Hervieu M, Biotti D, Caillier M, Ricolfi F, Moreau T, Giroud M. Dissémination sous-arachnoïdienne de gouttelettes lipidiques par rupture d’un kyste dermoïde intracérébral. Rev Neurol (Paris) 2010; 166:451-7. [DOI: 10.1016/j.neurol.2009.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 06/29/2009] [Accepted: 09/10/2009] [Indexed: 10/20/2022]
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Akhavan-Sigari R, Bellinzona M, Becker H, Samii M. Epidermoid cysts of the cerebellopontine angle with extension into the middle and anterior cranial fossae: surgical strategy and review of the literature. Acta Neurochir (Wien) 2007; 149:429-32. [PMID: 17380252 DOI: 10.1007/s00701-007-1117-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Accepted: 01/08/2007] [Indexed: 10/23/2022]
Abstract
Epidermoid cysts are tumours, which contain keratin, cellular debris and cholesterol, and lined with stratified squamous epithelium. Clinically, epidermoid cysts behave like benign, slow-growing lesions. We present a 63 year-old man with a 6-month history of right periorbital pain and hypaesthesia in the area of the first and second branch of the trigeminal nerve. MRI revealed an epidermoid cyst of the cerebellopontine angle extending into the middle and anterior cranial fossae. Radical surgical removal of epidermoid cysts should be attempted, but a less aggressive surgical strategy should be considered if there is strong adherence to the surrounding brain tissue, particularly in eloquent areas. In this case, complete tumour removal was achieved via a suboccipital retrosigmoid approach.
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Affiliation(s)
- R Akhavan-Sigari
- Department of Neurosurgery, Nordstadt Hospital, Hannover, Germany.
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