Intrinsic epidermoid of the brain stem: case report and review of the literature

Singh, Saraj Kumar; Jain, Kapil; Jain, Vibha

doi:10.1007/s00381-018-3774-1

Cited by 6 publications

(2 citation statements)

References 14 publications

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“…Epidermoids can be distinguished from arachnoid cysts and other CSF-contained structures on MRI by DWI, with the former characteristically showing significant restriction of diffusion. 11,25,26…”

Section: Differential Diagnosismentioning

confidence: 99%

“…6 Intracranial epidermoids are even more rare in the pediatric population, and brainstem epidermoids in children are extremely uncommon, with only scattered case reports in the literature, particularly in the MRI era. Of the reported cases in the past 20 years, only 13 were purely intrinsic brainstem epidermoids 1,3,[7][8][9][10][11][12][13][14] In this paper, we describe our experience with the diagnosis and successful management of a large, complex, symptomatic midline intrinsic brainstem epidermoid of the pontomedullary junction in a 2.5-year-old child, and review the literature on this benign but treacherous lesion.…”

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confidence: 99%

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Endoscope-assisted microsurgical resection of intrinsic brainstem epidermoid: technical note and review of the literature

Cohen

Stone

2020

Journal of Neurosurgery: Pediatrics

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Intrinsic epidermoid tumors of the brainstem are rare, histologically benign lesions associated with high surgical morbidity and mortality due to their eloquent location. The authors report a child with progressive severe neurological deterioration from a large midline intrinsic brainstem epidermoid at the pontomedullary junction. The mass was removed through a posterior fossa craniotomy and midline endoscope-assisted microsurgical corridor through the floor of the fourth ventricle, using neurophysiological monitoring. Postoperatively, there was dramatic improvement in the patient’s symptoms. Early recurrence of the mass necessitated reoperation with more aggressive resection of the cyst capsule, which led to complete radiographic reconstitution of the brainstem. The patient remains well with a durable recovery 7 years after presentation. The authors review the literature on brainstem epidermoids and discuss the differential diagnosis and management strategies for approaching these lesions, advocating for conservative surgery with resection of as much of the tumor capsule as is safely possible.

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Section: Differential Diagnosismentioning

confidence: 99%