Epidermoid Cyst With Erosion Into the Calvarial Intradiploic Space

Hornback, Cheyenne J.; Bax, Daniel; Holmes, Todd; Maloney, Mary

doi:10.1097/dss.0000000000003988

Cited by 1 publication

(2 citation statements)

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“…The treatment consists of surgical resection including the complete cystic wall to prevent recurrence [ 2 , 3 ]. A consensus regarding the extent of resection of adjacent bone structures is lacking [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

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Tension Pneumocephalus With Acute Cerebellar Symptoms Due to an Intradiploic Epidermoid Cyst Eroding the Mastoid Bone

Schepens,

Van Havenbergh,

Dejaegher

et al. 2024

Cureus

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This case report presents a unique presentation of an intradiploic epidermoid cyst (IDEC) in a 55-year-old female. She presented with acute cerebellar symptoms triggered by a Valsalva maneuver. IDECs are a rare type of intracranial epidermoid cysts. They are benign and have a slow growth pattern that translates into progressively developing symptoms instead of acute symptoms. Symptoms include local deformities, focal neurologic deficits, and pain. This patient developed acute cerebellar symptoms due to erosion of the mastoid bone that created a pathway between the eustachian tube and the intracranial space via the mastoid air cells. Consequently, tension pneumocephalus emerged via a ball-valve effect that caused a significant mass effect in the posterior fossa. Surgical resection of the IDEC and closing of the mastoid air cells resulted in symptom relief by restoring the integrity of the intracranial-extracranial barrier. This case highlights that a higher level of vigilance is warranted for an IDEC in the proximity of aerated bone structures, such as the mastoid air cells and the paranasal sinuses, and that a more proactive approach is advocated.

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Section: Discussionmentioning

confidence: 99%

“…In rare cases, a penetrating trauma might be the underlying etiology by introducing epithelial cells in the diploic space. This results in a sequestration of ectodermal remnants within the intradiploic space [ 2 , 3 ]. The most frequent location are the occipital, the frontal, and the parietal bone [ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%