THE LONG HISTORY OF A CEREBELLOPONTINE ANGLE EPIDERMOID TUMOR - A CASE-REPORT AND LESSONS LEARNED

The authors present the case of a patient accurately diagnosed and ope rated on for an epidermoid cyst in the CPA region, 30 years after the clinical onset with the initial symptom of hypoacusis. At the time of the operation, the patient presented with advanced CPA syndrome, and t he tumour had grown to an enormous size. Complete capsule removal was not attempted due to its tenacious adherence to vital neurovascular st ructures. Thirteen years after surgery, the patient underwent a second operation due to tumour regrowth. The case provides supporting eviden ce that the clinical findings of a CPA epidermoid cyst may be minimal, and remain so for extended periods of time until the tumour has sprea d widely. Epidermoids tend to insinuate in the cisterns around cranial nerves, blood vessels, and the brainstem, rather than compressing the se structures. The importance of early detection and radical removal, presently facilitated by Magnetic Resonance Imaging, is emphasized.