Congenital epidermoid cysts over the anterior fontanelle

Abstract

Epidermoid cysts over the anterior fontanelle were once regarded as rare and exclusive to blacks. The latest reports in the literature indicate a more widespread incidence. Only a few cases have been described in Europe. The authors report three cases of epidermoid cysts in this location occurring in Spaniards. Clinical, radiological, and surgical features are briefly discussed and pertinent literature is reviewed.

Clinical characteristics and diagnostic imaging of epidermoid tumors

“…These cells become trapped during neural tube closure and separation from the ectoderm between the 3rd and 5th weeks of intrauterine development. 2,3,[6][7][8] During this same period of embryogenesis, the otic and optic vesicles are also being formed, and it is believed that migration along these or other developing neurovascular structures accounts for the lateral displacement seen in most epidermoid cysts. 6,9,10 It is speculated that inclusions occurring prior to the third week of embryologic development may result in intraventricular and intracerebral lesions, as this coincides with formation of the primary cerebral vesicle.…”

Subgaleal Dermoid Tumors at the Anterior Fontanelle

“…However, several older infants with skull defects under a tumor have been reported [5,6]. Isozumi et al [7] also reported a 35-month-old boy with a dermoid cyst over an open anterior fontanelle and widely attached to the dura mater.…”

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“…6 In contrast, epidermoid cysts usually occur laterally, contain no skin appendages, and are thought to be an insult of later embryogenesis. 7,8 Only 2 cases of epidermoid cysts at the anterior fontanelle have been reported. 6 The first case series of dermoid cysts of the anterior fontanelle was reported by Adeloye and Odeku 12 in 1971.…”