Intracerebral epidermoid tumor: A case report and review of the literature

BACKGROUND Intracerebral epidermoid cysts are rare lesions and may account for only 1. 5% of intracranial epidermoid tumors. Cell entrapment from the mesectoderma l origin of the neural crest within the primitive cerebral hemisphere may l ead to the formation of such rare intracerebral lesions. METHODS An intracerebral epidermoid cyst located in the right temporal lobe that wa s surgically treated is presented. The origin, clinical course, radiologica l features, and surgical treatment of such uncommon lesions are discussed b ased on a review of the literature. RESULTS Intraoperative findings revealed an epidermoid tumor. The postoperative cou rse was uneventful and the patient was discharged with no neurological defi cits. On longterm follow-up (2 years), there were no signs of recurrence. CONCLUSIONS Truly intracerebral epidermoid tumors are rarely found, Cells originating f rom mesectodermal lines may migrate and remain trapped within the primitive cerebral hemisphere while the neural tube is closing, leading to the forma tion of such intraparenchymal epidermoid tumors. Accurate preoperative diag nosis can be very difficult due to the radiological similarities to other c ommon intracerebral cysts (e.g., astrocytomas or gliomas). Magnetic resonan ce imaging (MRI) studies, especially with diffusion-weighted images, allow greater accuracy in the preoperative differential diagnosis. Radical surgic al removal should be attempted, but a less aggressive surgical strategy sho uld be considered if there is strong adherence between the tumor capsule an d the brain tissue, particularly in eloquent areas. (C) 2001 by Elsevier Sc ience Inc.