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Epidermoid Cyst of the Brainstem in 3-Year-Old Child: A Rare Case Report

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Abstract

Epidermoid cysts are infrequent lesions occupying the intracranial space, comprising approximately 1–2% of all intracranial tumors. Brainstem epidermoids are exceptionally uncommon in children; up until now, only a few scattered case reports have been documented in the literature regarding this unique location. These cysts commonly arise from the inclusion of ectodermal elements during neural tube closure. Complete excision of these cysts is challenging due to their close proximity and adherence to the brainstem, which makes it difficult to achieve. As a result, recurrence of the cysts is not uncommon. We have reported a rare case of a 3-year-old with a 5-month history of progressive headache, imbalance while walking and progressive weakness in his right upper limb and lower limb along with difficulty in swallowing. On MRI Brain imaging study he had a pre-pontine epidermoid with intra-axial extension in the pons. The patient underwent retro-sigmoid/suboccipital craniotomy and microsurgical excision of the tumor, including the tumor capsule. After completing the surgery, the cavity was irrigated using a solution containing hydrocortisone and Ringer lactate to prevent the occurrence of aseptic meningitis. In the postoperative, the patient recovered without any complications, as all symptoms showed immediate improvement, and the lower cranial nerves returned to normal functioning.

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References

  1. Caldarelli M, Massimi L, Kondageski C, Di Rocco C (2004) Intracranial midline dermoid and epidermoid cysts in children. J Neurosurg 100:473–480

    PubMed  Google Scholar 

  2. Kachhara R, Bhattacharya RN, Radhakrishnan VV (2004) Epidermoid cyst involving the brain stem. Acta Neurochir (Wien) 142:97–100

    Article  Google Scholar 

  3. Rubin G, Scienza R, Pasqualin A, Rosta L, Da Pian R (1989) Craniocerebral epidermoids and dermoids. A review of 44 cases. Acta Neurochir (Wien) 97:1–16

    Article  CAS  PubMed  Google Scholar 

  4. Berger MS, Wilson CB (1985) Epidermoid cyst of the posterior fossa. J Neurosurg 62:214–219

    Article  CAS  PubMed  Google Scholar 

  5. Russell DS, Rubinstein LJ (1989) Pathology of tumors of the nervous system, 5th edn. Williams & Wilkins, pp 690–695

    Google Scholar 

  6. Urlich J (1964) Intracranial epidermoids: a study on their distribution and spread. J Neurosurg 21:1051–1058

    Article  Google Scholar 

  7. Grant FC, Austin GM (1950) Epidermoids: clinical evaluation and surgical results. J Neurosurg 7:190–198

    Article  CAS  PubMed  Google Scholar 

  8. Sabin HI, Bordi LT, Symon L (1987) Epidermoid cysts and cholesterol granulomas centered on the posterior fossa: 20 years of diagnosis and management. Neurosurgery 21:789–805

    Google Scholar 

  9. Yasargil MG, Abernathey CD, Sarioglu AC¸ (1989) Microneurosurgical treatment of intracranial dermoid and epidermoid tumors. Neurosurgery 24:561–567

    Article  CAS  PubMed  Google Scholar 

  10. Caldarelli M, Colosimo C, Di Rocco C (2001) Intra-axial dermoid/epidermoid tumors of the brainstem in children. Surg Neurol 56:97–105

    Article  CAS  PubMed  Google Scholar 

  11. Fournier D, Mercier P, Menei P, Pouplard F, Rizk T, Guy G (1992) Recurrent intrinsic brain stem epidermoid cyst. Childs Nerv Syst 8:471–474

    Article  CAS  PubMed  Google Scholar 

  12. Leal O, Miles J (1978) Epidermoid cyst in the brain stem. Case report. J Neurosurg 48:811–813

    Article  CAS  PubMed  Google Scholar 

  13. Obana WG, Wilson CB (1991) Epidermoid cyst of the brain stem. Report of three cases. J Neurosurg 74:123–128

    Article  CAS  PubMed  Google Scholar 

  14. Weaver EN Jr, Coulon RA Jr (1979) Excision of a brain stem epidermoid cyst. Case report. J Neurosurg 51:254–257

    Article  PubMed  Google Scholar 

  15. deSouza CE, deSouza R, da Costa S et al (1989) Cerebellopontine angle epidermoid cysts: a report on 30 cases. J Neurol Neurosurg Psychiatry 52:986–990

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Chen CY, Wong JS, Hsieh SC et al (2006) Intracranial epidermoid cyst with hemorrhage: MR imaging findings. AJNR Am J Neuroradiol 27:427–429

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Alvord EC Jr (1977) Growth rates of epidermoid tumors. Ann Neurol 2:367–370

    Article  PubMed  Google Scholar 

  18. Cobbs CS, Pitts LH, Wilson CB (1997) Epidermoid and dermoid cysts of the posterior fossa. Clin Neurosurg 44:511–528

    CAS  PubMed  Google Scholar 

  19. Eekhof JL, Thomeer RT, Bots GT (1985) Epidermoid tumor in the lateral ventricle. Surg Neurol 23:189–192

    Article  CAS  PubMed  Google Scholar 

  20. Toglia JU, Netsky MG, Alexander E Jr (1965) Epithelial (epidermoid) tumors of the cranium. Their common nature and pathogenesis. J Neurosurg 23:384–93

    Article  CAS  PubMed  Google Scholar 

  21. Guy G, Jan M, Guegan Y (1989) Leslesionschirurgicales du tronc cerebral. Neuochiurgie 35(Suppl 1):99–101

    Google Scholar 

  22. Malcolm GP, Gibson R, Ironside JW, Whittle IR (1996) Microsurgical excision of a pontomedullary epidermoid cyst with prepontine extension Case report. Neurosurgery 38:579–583

    CAS  PubMed  Google Scholar 

  23. Schwartz JF, Balentine JD (1978) Recurrent meningitis due to an intracranial epidermoid. Neurology 28:124–129

    Article  CAS  PubMed  Google Scholar 

  24. Dutt SN, Mirza S, Chavda SV, Irving RM (2002) Radiologic differentiation of intracranial epidermoids from arachnoid cysts. Otol Neurotol 23:84–92

    Article  PubMed  Google Scholar 

  25. Samii M, Tatagiba M, Piquer J, Carvalho GA (1996) Surgical treatment of epidermoid cysts of the cerebellopontine angle. J Neurosurg 84:14–19

    Article  CAS  PubMed  Google Scholar 

  26. Yamakawa K, Shitara N, Genka S, Manaka S, Takakura K (1989) Clinical course and surgical prognosis of 33 cases of intracranial epidermoid tumors. Neurosurgery 24:568–573

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Apurva Lachake.

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Gotecha, S., Chugh, A., Punia, P. et al. Epidermoid Cyst of the Brainstem in 3-Year-Old Child: A Rare Case Report. Indian J Otolaryngol Head Neck Surg 76, 1224–1228 (2024). https://doi.org/10.1007/s12070-023-04229-8

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