Case Report on White Epidermoid Cyst and Review of its Literature View PDF

^*Bharath K
Medicine, Sri Venkateshwara Medical College, Andhra Pradesh, India

^*Corresponding Author:

Bharath K
Medicine, Sri Venkateshwara Medical College, Andhra Pradesh, India
Email:korrapatibharath@gmail.com

Published on: 2022-06-11

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.

Keywords

Epidermoid Cysts, Benign Tumors

Introduction

Epidermoid cysts are rare slow-growing benign tumors constituting about 1.8% of all intracranial tumors [1,2]. These are congenital tumors, that arise from tissue sequestrated during the closure of the neural tube in embryogenesis [3]. Typically, an epidermoid cyst shows CSF density on CT and signal intensities broadly similar to CSF on T1 and T2 weighted MR sequences with heterogeneous signal suppression on FLAIR [4,5]. However very few cases have reported atypical imaging features and are called white epidermoid cysts. We report here a case of the epidermoid cyst with atypical imaging features in the cerebellopontine angle, which was radiologically diagnosed and further confirmed with histopathology and thereby briefly review its literature.