Background: Epidermoid cysts (EC) are relatively rare congenital lesions. They arise from ectodermal debris during aberrant closure of the neural tube, are benign, and of slow growth. They are found predominantly in the cistern of the cerebellopontine angle, most are intradural, and very rarely, there is underlying compression of the venous sinuses, leading to benign intracranial hypertension.
Case description: We present the case of a patient diagnosed with a giant extradural, intradiploic EC with compression of the left transverse sinus and its successful management by using ultrasonic aspiration, performing a combined supra-infratentorial retromastoid approach with occipitotemporal craniotomy, without subsequent residual tumor.
Conclusion: We report the diagnostic approach of the EC and its successful management without the added neurological deficit and considerable improvement in previous symptoms. The retromastoid approach is a safe and effective approach for managing these tumors, including complete resection of the cystic and capsular components. However, it requires adequate surgical management with prior planning, a multidisciplinary therapeutic approach, and long-term follow-up, given the possibility of recurrence.
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Almendárez-Sánchez, César Adán; Solorio-Pineda, Saúl; Tafur-Grandett, Abrahan Alfonso; Ramírez-Sosa, Miguel Ángel Dr.; Ramos Martínez, Gabriel Arturo; and Álvarez-Vázquez, Leonardo
"An unusual case of a giant intradiploic epidermoid cyst removed using a combined supra-infratentorial retromastoid approach.,"
Archives of Neurosurgery: Vol. 1:
2, Article 7.
Available at: https://www.ansjournal.org/home/vol1/iss2/7