Intracavernous epidermoid cyst. Case report and review of the literature

We report an unusual case of epidermoid cyst located in the cavernous sinus . Only two cases of epidermoid cyst of the cavernous sinus have been report ed in the literature. In 1995, a 61-year-old man experienced diplopia, whic h resolved spontaneously. Imaging findings, particularly magnetic resonance , showed a cavernous sinus armor, The MR appearance was compatible with epi dermoid cyst. Since the patient was, at the time, asymptoma tie, we propose d clinical and MR surveillance. In 1999, he developed a right III palsy wit h V1 and V2 hypoesthesia. The size of the cavernous tumor had increased on the control MR and the patient was operated via an extradural temporopterio nal approach through the Dolenc lateral triangle. We used a neuroendoscope to perform total resection of the tumor cyst. The extradural approach to th e cavernous sinus and use of a neuroendoscope allowed complete removal of t he cyst and shortened postoperative care. The patient, was discharged on da y 5 after surgery. These techniques provided a good view of the tumor witho ut orbitozygomatic or zygomatic osteotomy. The 30 degrees neuroendoscope al lowed visual control of tumor removal that was better than a direct microsc ope view.