Intraventricular epidermoids

Abstract

To study the clinical characteristics of intraventricular epidermoids, we analysed retrospectively 12 patients treated in our hospital and reviewed the literature with regard to clinical manifestations, imaging features, diagnosis, surgical procedures and prognosis. Four patients with lateral ventricle epidermoid and eight in the fourth ventricle were included in this group. Intraventricular epidermoids are characteristically hypodense non-enhancing lesions on CT scans. MRI reveals them to have long T1 and T2 relaxation times with slight mass effect. Total removal is ideal, but special attention should be paid to preservation of important neurovascular structures. Close proximity of tumours to cranial nerves and the brain stem pose technical difficulties in total removal. Cranial nerve dysfunction and aseptic meningitis are the main postoperative complications. Long-term prognosis for patients with intraventricular epidermoids and well-preserved neurological conditions is good, even in the case of subtotal excision. Clinical follow-up and MRI allow earlier diagnosis of recurrence.

Epidermoid cysts of the velum interpositum

“…[4][5][6][7][8][9] It is often difficult to determine the precise site of origin of tumors, particularly when they are very large or are in relation to the lateral ventricles. 10 We suggest that the epidermoid cysts arose from misplaced epithelial tissues within the velum interpositum; however, it may be argued that they arose instead from the quadrigeminal cistern and extended into a pre-existing cavum velum interpositum, in the light of their tendency to extend along CSF pathways. However, Desai et al 11 reported a series of quadrigeminal cistern epidermoid cysts that displaced the third ventricle anteriorly and did not enter the ventricles or velum interpositum despite being large.…”

Epidermoid tumour within the collateral sulcus: A rare location and atypical presentation

“…19 However, only a few cases of ETs located within the lateral ventricles have been reported. [20][21][22][23][24][25] In our case, the location of the ET was within the depths of the collateral sulcus, located between the parahippocampal and fusiform gyri. The tumour did not originate from the brain parenchyma or the lateral ventricle, but extended into the floor of the temporal horn of the lateral ventricle through the collateral sulcus.…”

Epidermoid Cyst Located in the Fourth Ventricle: Case Report and Review

“…3 In the case of tumors located in the fourth ventricle, the approach of choice is to perform a median sub occipital craniotomy. 9,10 The surgical excision is based on the intracapsular debulking and extracapsular dissection. 11 However, two complications may alter the course of the disease: aseptic meningitis and malignant transformation.…”

“…11 However, two complications may alter the course of the disease: aseptic meningitis and malignant transformation. 9 Aseptic meningitis is the main influencing factor of postoperative course. 12 It does not occur only when performing partial excision of the lesion, as classically described.…”