A Case of Dermoid Cyst Arising in the Temporal Lobe

Abstract

Intracranial dermoid cysts are rare congenital lesions that result from abnormal sequestration of ectodermal cells during neural tube formation. These tumors are especially rare in lateral areas such as in the temporal lobe. In this study, we report a case of dermoid cyst located in the right temporal lobe. A 50-year-old man was referred for further treatment of a tumor. CT revealed a low-density mass lesion in the right temporal lobe, with calcification. MRI showed the lesion with high signal intensity on diffusion-weighted imaging, high-low mixed signal intensity on T1-weighted imaging, and iso-high signal mixed intensity on T2-weighted imaging; the capsule was enhanced with gadolinium. Differential diagnosis included dermoid cyst, epidermoid cyst, teratoma, and neurenteric cyst. We decided to perform surgery for the improvement of his symptom, histopathological diagnosis, and radical cure. A right temporal craniotomy was performed, and the tumor was found adherent to the surrounding brain tissue. The tumor was completely removed under subpial dissection. Hair was confirmed in the tumor content. On histopathology, the cyst wall was lined with stratified squamous epithelium, sebaceous glands, small vessel aggregates, and inflammatory infiltrate. Keratinized material and hair were found in the lumen. The patient was discharged 7 days after surgery with no new neurologic deficits. This case was unusual in terms of the effect of gadolinium enhancement on MRI, and the presence of adipose tissue and calcification were useful for diagnosis. It is vital to consider prevention of chemical meningitis due to intrathecal dissemination of the tumor content intraoperatively.

Growing Pains: A Rare Case of a Temporal Dermoid Cyst in an Adult and Review of the Literature

“…These inclusions occur between the third and fifth weeks of fetal development. 5 Dermoid cysts arising from the temporal region are extremely rare, even more so in adults, with only a handful of cases reported in the current literature. Considering the unique presentation of our case, the authors aim to provide an updated guide to diagnosis and treatment of a temporal dermoid cyst in an adult.…”

“…Therefore, excessive resection should be avoided. 5 A temporal dermoid cyst typically requires complete surgical excision with the aim of removing the entire cyst while preserving the integrity of nearby structures and maintaining aesthetic standards. In our case, a short zig-zag shaped temporal incision was used to approach the cyst.…”

“…1 To the best of our knowledge, few cases of a temporal dermoid cyst have been reported in the literature, with even fewer of those patients being older than 18 years of age. [2][3][4][5][6] We present the case of a 51-year-old female with an enlarging extracranial left temporal mass found to be a dermoid cyst. Dermoid cysts are common cutaneous developmental anomalies that arise from the entrapment of ectodermal elements along the lines of embryonic closure.…”

Marsupialization of a Floor-of-Mouth Dermoid Cyst to Temporize Airway Distress

“…Dermoid cysts are uncommon congenital formations that can occur in diverse regions of the human body such as the head, neck, retroperitoneum, ovaries, and brain [5][6][7][8][9]. These cysts commonly present in the head and neck region; most of which, however, are diagnosed before the age of five years old [5].…”

“…In the case of head and neck dermoid cysts, entrapment can occur during fusion of the five pharyngeal arches and fascial processes that occur during weeks four to eight of development [1,10]. Dermoid cysts are comprised of keratinized stratified squamous epithelial lining, which contains adnexal structures such as hair follicles, sebaceous glands, and eccrine glands [7]. The presence of these adnexal structures is what differentiates a dermoid cyst from an epidermoid cyst.…”