Dermoid cyst of the lateral ventricle associated with a ethmoidal dermal sinus tract

We report a case of a ventricular dermoid cyst associated with a dermal sin us connected with the ethmoidal cells in a patient who developed rapid symp toms of raised intracranial pressure. Computed tomography showed a cystic mass in the right lateral ventricle wit h a hydrolipidic image in the left frontal horn of the ventricle and associ ated hydrocephalus. Magnetic resonance imaging showed a heterogeneous TI hy perintense mass with a fistulous tract communicating with the ethmoid cells . A cerebrospinal fluid ventriculo-peritoneal shunt was initially establish ed, which required further revision. A right sided transventricular approac h was undertaken in a second stage, allowing resection of a dermoid cyst. O bliteration of the dermal sinus tract was obtained using pericranial durapl asty. Clinical and imaging features are discussed. The need for total resec tion including the tumor capsule and occlusion of the fistula are emphasize d if recurrence and infection are to be prevented.