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.     

阴囊内大体积表皮样囊肿1例报告并文献复习

目的:探讨阴囊内大体积表皮样囊肿的疾病特点,提高对阴囊内大体积表皮样囊肿的临床诊治水平。方法:回顾性分析1例阴囊内大体积表皮样囊肿患者临床资料,男,50岁,发现右侧阴囊内肿物40余年,呈进行性长大。右侧阴囊内可触及直径约为7.0cm大小椭圆形肿物,界清,质硬,触痛阴性。阴囊彩超提示右侧阴囊内有囊性肿物,大小约7.7cm×4.7cm×5.0cm,与睾丸界清。在腰硬联合麻醉下行右侧阴囊内肿物切除术。结果:术后患者预后良好。切除病变组织送病检,证实为阴囊内表皮样囊肿。结论:阴囊内表皮样囊肿是阴囊罕见的良性肿瘤,一般无明显不适,肿物可缓慢生长,目前确诊依赖于术后病检。对于阴囊内表皮样囊肿应尽早手术切除,但易复发,应长期随访。     

Splenic epidermoid cyst. Clinical case and review of the literature

The occasional discovery of an epidermoid cyst of the spleen, rare kind of lesion, in a 25 years old man who underwent a US for urethral colic, permit to the authors a review of the literature. Treatment is individualized in a partial or total splenectomy.     

Extradural thoracic arachnoid cyst. Case report and review of the literature

OBJECTIVE: To report an unusual and asymptomatic cause of cord compression treated surgically with good clinical outcome. METHODS AND MATERIAL: We report a case of extradural arachnoid cyst in the thoracic region and review the literature on the clinical, neuroradiologic and therapeutic features. RESULTS: A 17-year-old man, with unremarkable past medical history was referred to our institution of Neurosurgery, CHU Mohammed-VI, Marrakech, with progressive spastic paraparesis. Magnetic resonance imaging (MRI) showed a posterior extradural cystic lesion in the thoracic region from T6-T7 thoracic vertebra. The cyst was completely removed by posterior approach. An arachnoid cyst was confirmed at the histological study. Neurological symptoms improved after surgery. CONCLUSION: Given its infrequency, the diagnosis of arachnoid cyst should be suspected when a cystic lesion causes cord compression. Surgery is the treatment of choice, providing good clinical outcome.     

Giant prebulbomedullary arachnoid cyst. Case report and review of the literature

Usual locations of arachnoid cyst are the middle cranial fossa in 50-60%, cerebellopontine angle (10%) and suprasellar area (10%). Most of these malformations are asymptomatic. Premedullar arachnoid cysts are extremely rare. All previous cases reported were operated. We report a case of an asymptomatic giant craniocervical junction arachnoid cyst with a follow up of five years. In 2002, an adolescent consulted for persistent cervical pain. Encephalic MR showed a giant ventral craniocervical junction arachnoid cyst. Neurologic examination was normal. Conservative treatment was decided with a clinical follow up and repeated MR in case of persistent cervicalgia. Craniocervical junction arachnoid cysts are anecdotic. Medical care cannot be standardized. Pathogenesis and management 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.     

Tarlov cyst: Case report and review of literature

We describe a case of sacral perineural cyst presenting with complaints of low back pain with neurological claudication. The patient was treated by laminectomy and excision of the cyst. Tarlov cysts (sacral perineural cysts) are nerve root cysts found most commonly in the sacral roots, arising between the covering layer of the perineurium and the endoneurium near the dorsal root ganglion. The incidence of Tarlov cysts is 5% and most of them are asymptomatic, usually detected as incidental findings on MRI. Symptomatic Tarlov cysts are extremely rare, commonly presenting as sacral or lumbar pain syndromes, sciatica or rarely as cauda equina syndrome. Tarlov cysts should be considered in the differential diagnosis of patients presenting with these complaints.     

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.     

Petrous bone epidermoid cyst caused by penetrating injury to the external ear: Case report and review of literature

Epidermoid cysts are histologically benign, slow-growing congenital neoplasms of the central nervous system that may arise from retained ectodermal implants. The epidermoid lesions are generally caused during the 3(rd) to 5(th) week of gestation by an incomplete cleavage of the neural tissue from the cutaneous ectoderm, though it can also happen later in life due to introduction of skin elements by skin puncture, trauma or surgery. We present this unique case of a petromastoid epidermoid cyst associated with ipsilateral cerebellar abscesses, presenting 20 years after a penetrating trauma to the external auditory canal. Radical excision of both lesions and revision of the previous fistulous tract was performed. We present the diagnostic challenge and the operative treatment of this unique case, which to our knowledge is the first where an epidermoid cyst and an adjacent brain abscess occurred as a result of a single traumatic event.     

Peripontomedullary hydatid cyst: Case report and literature review

Introduction: Hydatid cyst represents the parasitic infection by Genus Echenococcus Granulosis. This disease usually involves liver followed by lungs and rarely the CNS. The CNS involvement by the Hydatid Cyst is present in 1–2% of all hydatidosis. Even when it is found in the Brain it presents usually in the supratentorial compartment. However this case was unique in having the Hydatid cyst within the infratentorial fossa. With multiple small cysts, causing mass effect and challenging for surgical resection.Presentation: A 44 years female presented with headache, diplobia and bulbar symptoms, followed by ataxia. Full examination, proper investigations showed the peripontomedullary hydatid cysts. Surgical management is illustrated.Discussion: It is still challenging for the neurosurgeons to operate on these lesions in spite of modern technologies and fancy approaches due to its delicate nature, associated risk of allergic reaction, cyst’s material dissemination and irreversible injury of multiple neurological structure due to prolonged compression of cranial nerves crossing the cerebellopontine angle.Conclusion: In this case report we are presenting a rare case of Multiple Hydatid cysts involving a rare location in the brain; peripontomedullary area and extending all the way down to the foramen magnum. Supported with a literature review in relation to disease etiology, epidemiology, clinical presentation and management.     

Multiple complications from an intracranial epidermoid cyst: case report and literature review

Intracranial epidermoid and dermoid tumors are unusual benign lesions that are potentially curable. Subtotal removal carries a high incidence of recurrence, plus the rare possibility of carcinomatous degeneration of the remnants. Aseptic meningitis from spillage of cyst contents into the subarachnoid space is frequent after operation and has been reported to occur spontaneously. A case of a patient with a posterior fossa epidermoid cyst presenting with multiple bouts of aseptic meningitis in which squamous cell carcinoma arose in recurrent tumor 5 years after subtotal removal of the benign lesion is described.     

Sacral epidural noncommunicating arachnoid cyst. Case report and review of the literature

The authors examine the natural history of a spinal epidural arachnoid cyst and present their experience with its treatment in a 25-year-old man who presented with progressive cauda equina syndrome. Neuroimaging revealed two neighboring sacral epidural cysts. The cysts were completely removed via a sacral S1-4 laminectomy; no communication with the subarachnoid space could be found. The patient's postoperative course was uneventful. He experienced progressive improvement and, finally, complete resolution of symptoms and no recurrence of the cyst. Nabors Type I sacral epidural arachnoid cysts are rare; in some cases their origins and the mechanism by which they cause deterioration in the patients' clinical condition are debatable. Findings in the present case support the idea that some of these cysts are noncommunicating but progressive in their clinical presentation. This lesion type is also known to occur intracranially. A brief review of the literature is provided.     

Neurenteric cyst of the posterior fossa. Case report and review of the literature

Intracranial neurenteric cysts are rare entities. The term is currently used to describe epithelial cysts that are lined with a presumed endodermal-derived epithelium and are mostly located in the posterior fossa.Preoperative diagnosis is often difficult because of their clinical presentation, which may resemble a subarachnoid hemorrhage, and the radiological aspect, which can mimic vascular pathologies.We describe a posterior fossa neurenteric cyst in a 27-year-old woman, who presented with sudden headache as the only symptom and who was addressed to our hospital for subarachnoid hemorrhage. Diagnostic angiography was negative and MRI revealed a prepontine cystic lesion. The patient underwent a posterolateral approach on the right side, with subtotal resection of the lesion.We discuss the embryologic, diagnostic and therapeutic aspects of these cysts and review the literature.     

Mucoid cyst of the penis: Case report and literature review

Penile cysts are uncommon lesions. In general, they are asymptomatic and do not interfere with sexual function. Most of them are present since birth, but usually they are only detectable in adolescence or adulthood. We report a rare case of a young adult man with a 5 × 5-cm nodule on the prepuce (ventral face), which appeared 2 years ago and interfered with his sexual function. The nodule was excised by circumcision and a histopathologic study was performed. Histopathologic examination revealed a mucoid cyst of penis with epidermoid metaplasia. No recurrence was observed at a 6 months follow-up and the patient’s sexual function returned to normal.     

机器人辅助腹腔镜切除盆腔表皮样囊肿1例报告并文献复习

目的:结合文献探讨腹膜后表皮样囊肿的诊治方法,介绍机器人辅助腹腔镜切除盆腔腹膜后巨大肿瘤的手术经验。方法:为1例青年男性盆腔腹膜后巨大肿瘤患者行机器人辅助腹腔镜手术切除,并结合文献探讨腹膜后表皮样囊肿的诊治方法。结果:患者行机器人辅助腹腔镜下表皮样囊肿切除术,手术完整切除肿瘤,手术时间1.5 h、出血量约8 ml。术后病理诊断为表皮样囊肿。术后1周出院,随访8个月未见囊肿复发及转移。结论:腹膜后表皮样囊肿在临床症状上缺乏特异性,需要与脊索瘤、畸胎瘤等相鉴别;因有感染、恶变的倾向,治疗上应手术切除。机器人辅助腹腔镜手术治疗位于盆腔的腹膜后巨大肿瘤具有良好的适应性。     

Choledochal cyst with perforation--an unusual presentation. Case report and review of the literature

A unique case of a 22-month-old baby girl with a perforated choledochal cyst, who presented with vague abdominal symptoms but without any jaundice, an acute abdomen and an incidental finding of acholic stools, is described below with a review of the literature.