Case Report on White Epidermoid Cyst and Review of its Literature

Abstract

Background: Epidermoid cysts are rare slow-growing benign tumors showing typical imaging features in CT and MRI. However, few epidermoid cysts were reported to have atypical imaging features. Such epidermoid cysts are called ‘white epidermoids’. Hereby we report a case of white epidermoid localized in the right cerebellopontine angle.

Case Description: 26-year-old female without any known co-morbidities presented with occipital headache and vomiting for the previous 1 month. Headache was associated with neck pain on the right side. Her clinical examination shows a positive Romberg test. Further, Magnetic resonance imaging was advised. On MR, a well-defined lobulated T1 hyper-intense and T2 hypo intense extra-axial lesion was noted involving cisterna magna. The lesion was showing a focal area of blooming within, with no area of diffusion restriction. Radiologically it was diagnosed as a white epidermoid cyst. The patient underwent surgery and the excised mass was sent for histopathological examination. Histopathology was consistent with an epidermoid cyst showing a cyst wall lined by keratinizing stratified squamous epithelium with hemorrhage into the cyst cavity. The patient had an uneventful post-operative period.

Conclusion: White epidermoid cysts are extremely rare. Atypical imaging features of epidermoid cysts should always be considered while differentiating an epidermoid cyst from other lesions.