Intramedullary epidermoid cyst. A case report

The authors add to the literature a case report of a 32-year-old man with an intramedullary epidermoid cyst at the level of D 3/4, that was successfully operated on. There are several previous reports in the literature, but only five of these include MRI studies.     

Intracavernous epidermoid cyst. Case report and review of the literature

We report an unusual case of epidermoid cyst located in the cavernous sinus. Only two cases of epidermoid cyst of the cavernous sinus have been reported in the literature. In 1995, a 61-year-old man experienced diplopia, which resolved spontaneously. Imaging findings, particularly magnetic resonance, showed a cavernous sinus tumor. The MR appearance was compatible with epidermoid cyst. Since the patient was, at the time, asymptomatic, we proposed clinical and MR surveillance. In 1999, he developed a right III palsy with V1 and V2 hypoesthesia. The size of the cavernous tumor had increased on the control MR and the patient was operated via an extradural temporopterional approach through the Dolenc lateral triangle. We used a neuroendoscope to perform total resection of the tumor cyst. The extradural approach to the cavernous sinus and use of a neuroendoscope allowed complete removal of the cyst and shortened postoperative care. The patient was discharged on day 5 after surgery. These techniques provided a good view of the tumor without orbitozygomatic or zygomatic osteotomy. The 30 neuroendoscope allowed visual control of tumor removal that was better than a direct microscope view.     

超声诊断骶尾部表皮囊肿1例

患者女,40岁,因直肠憋胀感6个月、外院发现盆腔包块4天来我院就诊。经腹超声：膀胱充盈好,子宫及双侧卵巢结构未见明显异常,盆腔未见明显包块和积液。经阴道超声：直肠后方见约7.3 cm×3.5 cm囊实性包块,形态不规则,似＂哑铃＂型,边界清,似有包膜,内部回声偏低,不均匀,     

Orbital epidermoid cyst. Case report

Epidermoid tumors represent 1% of all primary intracranial tumors. Most of them occur intradurally in cerebellopontine angle and parasellar citerns. The intra-orbital location accounts for 4 to 5% of all primary intra-orbital tumors. We report the case of a 23-year-old girl with progressive right proptosis who had developed 6 months earlier. The tumor was removed via an external orbitotomy approach. Histology confirmed the diagnosis.     

Intramedullary epidermoid cysts of the spinal cord. Case report.

Epidermoid cysts are tumors familiar to neurosurgeons, but intramedullary epidermoid cysts are rare. The authors report the case of a 6-year-old girl presenting with progressive paraparesis. A midthoracic intramedullary mass was revealed on myelography and magnetic resonance (MR) imaging and confirmed as an intramedullary epidermoid cyst at surgery, at which time the cyst was removed. This is the fourth report documenting a purely intramedullary epidermoid cyst occurring in a child. The pathology and etiology, epidemiology, clinical features, radiology (including MR image characteristics), and surgical treatment of such rare intramedullary benign tumors are discussed. Magnetic resonance imaging reduces the delay in diagnosis of spinal cord tumors but should be guided by clinical judgment.     

Testicular epidermoid cyst: uncommon lesion of difficult preoperative diagnosis

Intratesticular epidermoid cysts are rare tumours that constitute one percent of all testicular masses. They are bening lesions that make differential diagnosis from malignant testicular tumours difficult. The absence of serum markers elevation and ultrasound imaging could support these lesions being bening epidermoid cysts, and in that case, conservative surgery is adequate. We present the case of a 22 years old patient who complains of a left testicular mass. In this case ultrasound diagnosis was non-specific and a left radical inguinal orchiectomy was performed.     

Intramedullary epidermoid cyst of the cervical spinal cord associated with an extraspinal neuroenteric cyst: case report.

A 4-year-old girl presented with an intramedullary epidermoid cyst of the cervical spinal cord. The clinical, radiological, and surgical features and a brief critical review of the literature are included in this report. The cyst contents were removed totally in two operations. The child had a coexisting neuroenteric cyst in the posterior mediastinum. To our knowledge, this coexistence has not been previously reported. Contemporary imaging modes and prospects of the surgical treatment are discussed.     

Excision of a brain-stem epidermoid cyst. Case report.

An intra-axial epidermoid cyst of the brain stem is presented. X-ray studies revealed a mass within the brain stem; computerized tomography showed the mass to be cystic. The epidermoid cyst was successfully removed surgically. Six months after operation the patient is stable with sixth and seventh nerve palsies but resolution of right spastic hemiparesis.     

Brainstem epidermoid cyst in a child. Case report

A 10-year-old girl presented with a brainstem epidermoid cyst manifesting as dysphagia and post-prandial vomiting. Magnetic resonance imaging disclosed a cystic mass in the brainstem with associated hydrocephalus. She was treated under a presumptive diagnosis of abscess until the definitive histological diagnosis was established at the fourth admission. In spite of four interventions, she remained in good condition with minimal cranial nerve pareses. Subtotal removal of the epidermoid cyst in the brainstem results in recurrence within a relatively short period, especially in children. Total resection of the tumor is the optimum treatment. The differential diagnosis includes abscess, cystic glioma, and neurenteric cyst.     

Intramedullary neurenteric cyst without an associated malformation. Case report

The authors report a case of an intramedullary neurenteric cyst without any associated dysraphic lesion. Unlike extramedullary intradural forms, this type of malformation remains rare. Our observation is one of the first to have been evaluated by magnetic resonance imaging. Theories concerning the embryogenesis of neurenteric cysts as well as their clinical characteristics and surgical treatment are discussed.     

Intramedullary spinal cord sarcoidosis. Case report and review of the literature

Sarcoidosis is a multisystemic granulomatosis disease of unknown etiology which commonly involves hilary nodes and lungs. Involvement of the nervous system represents 5 to 15% of the cases. We report on a rare case of cervicothoracic spinal cord sarcoidosis in an African man and review the literature on the subject. His only symptoms were those of a subacute myelopathy. On MR-imaging, coexistence of abnormal signal of cervicothoracic spinal cord with mediastinal lymph nodes was suggestive of sarcoidosis, which was confirmed by bronchial biopsies making unnecessary biopsies of the spinal cord lesion. Under corticotherapy both symptoms and radiological abnormalities rapidly regressed. We emphasize the rarity of sarcoidosis exclusively revealed by a myelopathy. We stress the importance of searching other localizations which are easier and safer to biopsy than the spinal cord lesion itself and illustrate the MR appearances of the lesion which are suggestive, however not specific of the disease.