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Intracranial Epidermoid Tumors: A Continuing Diagnostic Challenge

Intracranial Epidermoid Tumors: A Continuing Diagnostic Challenge Abstract • Epidermoid tumors are benign, slowly growing intracranial masses that still present difficulty in preoperative diagnosis. This article reviews six cases of histologically proven epidermoid tumors. Computed tomography and magnetic resonance imaging were complementary in their evaluation. Computed tomography demonstrated a hypodense, smoothly contoured extra-axial paramedian mass with lower density than cerebrospinal fluid. Magnetic resonance imaging usually demonstrated an irregularly but sharply marginated mass with inhomogeneous density, variable enhancement with gadolinium, lack of edema in adjacent normal structures, extensive insinuation into cisternal and other cerebrospinal fluid spaces, and a high-signal intensity on proton-weighted images. Multiplanar magnetic resonance imaging was extremely helpful in displaying the full anatomic extent of the lesion and its relationship with other structures. References 1. Alvord EC Jr. Growth rates of epidermoid tumors . Ann Neurol . 1977;2:367-369.Crossref 2. Bailey P. Cruveilhier's 'tumeur perlée.' Surg Gynecol Obstet . 1920;31:390-401. 3. Berger MS, Wilson CB. Epidermoid cysts of posterior fossa . J Neurosurg . 1985;62:214-219.Crossref 4. Russell DS, Rubinstein LJ. Pathology of Tumors of the Central Nervous System . Baltimore, Md: Williams & Wilkins; 1977:30-31. 5. Tytus JS, Pennybaker J. Pearly tumors in relation to the central nervous system . J Neurol Neurosurg Psychiatry . 1956;19:241-259.Crossref 6. Ulrich J. Intracranial epidermoids: a study on their distribution and spread . J Neurosurg . 1964;21:1051-1058.Crossref 7. Grant FC, Austin GM. Epidermoids: clinical evaluation and surgical results . J Neurosurg . 1950;7:190-198.Crossref 8. Guidetti B, Gagliardi FH. Epidermoid and dermoid cysts: clinical evaluation and surgical results . J Neurosurg 1977;47:12-18.Crossref 9. Choremis C, Economos D, Papadatos C, Gargdulas A. Intraspinal epidermoid tumours (cholesteatomas) in patients treated for tuberculous meningitis . Lancet . 1965;2:437-439. 10. Davis KR, Roberson GH, Taveras JM, New PJ, Trevor R. Diagnosis of epidermoid tumor by computed tomography . Radiology . 1976;119:347-353.Crossref 11. Davidson SI, Small JM. Malignant change in an intracranial epidermoid . J Neurol Neurosurg Psychiatry . 1960;23:176-178.Crossref 12. Love GI, Kernohan JW. Dermoid and epidermoid tumors (cholesteatomas) of the central nervous system . JAMA . 1936;107:1876-1883.Crossref 13. Chambers AA, Lukin RR, Tomsick TA. Cranial epidermoid tumors: diagnosis by computed tomography . Neurosurgery . 1977;1:276-280.Crossref 14. Dee RH, Kishore PRS, Young HF. Radiological evaluation of cerebello-pontine angle epidermoid tumor . Surg Neurol . 1980;13:293-296. 15. Fein JM, Lipow K, Taati F, Lansem T. Epidermoid tumor of the cerebellopontine angle: diagnostic value of computed tomographic metriza-mide cisternography . Neurosurgery . 1981;9:179-182.Crossref 16. Braun IF, Naidich TP, Leeds NE, et al. Dense intracranial epidermoid tumors . Radiology . 1977;122:717-719.Crossref 17. Nagashima C, Takahama M, Sakaguchi A. Dense cerebellopontine epidermoid cyst . Surg Neurol . 1981;17:172-177.Crossref 18. Davidson D, Ouchi T, Steiner RE. NMR imaging of congenital intracranial germinal layer neoplasms . Neuroradiology . 1985;27:301-303.Crossref 19. Latack JT, Kartush JM, Kemink JL. Epidermoidomas of the cerebellopontine angle and temporal bone: CT and MR aspects . Radiology . 1985;157:361-366.Crossref 20. Olson JJ, Beck DW, Crawford SC, Menezes AH. Comparative evaluation of intracranial epidermoid tumors with computed tomography and magnetic resonance imaging . Neurosurgery . 1987;21:357-360.Crossref 21. Vion-Drury J, Vincentelli F, Jiddane M, et al. MR imaging of epidermoid cysts . Neuroradiology . 1987;29:333-338.Crossref 22. Rooney MS, Poon PY, Wortzman G. Magnetic resonance imaging of intracranial epidermoids: report of two cases . J Can Assoc Radiol . 1987;38:283-287. 23. Kortman KE, Bradley WG. Supratentorial neoplasms . In: Stark DD, Bradley WG, eds. Magnetic Resonance Imaging . St Louis, Mo: CV Mosby Co; 1988:405. 24. Brooks ML, Jolesz FA, Patz S. MRI of pulsatile CSF motion within arachnoid cysts . Magn Reson Imaging . 1988;6:575-584.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Intracranial Epidermoid Tumors: A Continuing Diagnostic Challenge

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References (27)

Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1990.00530070111020
Publisher site
See Article on Publisher Site

Abstract

Abstract • Epidermoid tumors are benign, slowly growing intracranial masses that still present difficulty in preoperative diagnosis. This article reviews six cases of histologically proven epidermoid tumors. Computed tomography and magnetic resonance imaging were complementary in their evaluation. Computed tomography demonstrated a hypodense, smoothly contoured extra-axial paramedian mass with lower density than cerebrospinal fluid. Magnetic resonance imaging usually demonstrated an irregularly but sharply marginated mass with inhomogeneous density, variable enhancement with gadolinium, lack of edema in adjacent normal structures, extensive insinuation into cisternal and other cerebrospinal fluid spaces, and a high-signal intensity on proton-weighted images. Multiplanar magnetic resonance imaging was extremely helpful in displaying the full anatomic extent of the lesion and its relationship with other structures. References 1. Alvord EC Jr. Growth rates of epidermoid tumors . Ann Neurol . 1977;2:367-369.Crossref 2. Bailey P. Cruveilhier's 'tumeur perlée.' Surg Gynecol Obstet . 1920;31:390-401. 3. Berger MS, Wilson CB. Epidermoid cysts of posterior fossa . J Neurosurg . 1985;62:214-219.Crossref 4. Russell DS, Rubinstein LJ. Pathology of Tumors of the Central Nervous System . Baltimore, Md: Williams & Wilkins; 1977:30-31. 5. Tytus JS, Pennybaker J. Pearly tumors in relation to the central nervous system . J Neurol Neurosurg Psychiatry . 1956;19:241-259.Crossref 6. Ulrich J. Intracranial epidermoids: a study on their distribution and spread . J Neurosurg . 1964;21:1051-1058.Crossref 7. Grant FC, Austin GM. Epidermoids: clinical evaluation and surgical results . J Neurosurg . 1950;7:190-198.Crossref 8. Guidetti B, Gagliardi FH. Epidermoid and dermoid cysts: clinical evaluation and surgical results . J Neurosurg 1977;47:12-18.Crossref 9. Choremis C, Economos D, Papadatos C, Gargdulas A. Intraspinal epidermoid tumours (cholesteatomas) in patients treated for tuberculous meningitis . Lancet . 1965;2:437-439. 10. Davis KR, Roberson GH, Taveras JM, New PJ, Trevor R. Diagnosis of epidermoid tumor by computed tomography . Radiology . 1976;119:347-353.Crossref 11. Davidson SI, Small JM. Malignant change in an intracranial epidermoid . J Neurol Neurosurg Psychiatry . 1960;23:176-178.Crossref 12. Love GI, Kernohan JW. Dermoid and epidermoid tumors (cholesteatomas) of the central nervous system . JAMA . 1936;107:1876-1883.Crossref 13. Chambers AA, Lukin RR, Tomsick TA. Cranial epidermoid tumors: diagnosis by computed tomography . Neurosurgery . 1977;1:276-280.Crossref 14. Dee RH, Kishore PRS, Young HF. Radiological evaluation of cerebello-pontine angle epidermoid tumor . Surg Neurol . 1980;13:293-296. 15. Fein JM, Lipow K, Taati F, Lansem T. Epidermoid tumor of the cerebellopontine angle: diagnostic value of computed tomographic metriza-mide cisternography . Neurosurgery . 1981;9:179-182.Crossref 16. Braun IF, Naidich TP, Leeds NE, et al. Dense intracranial epidermoid tumors . Radiology . 1977;122:717-719.Crossref 17. Nagashima C, Takahama M, Sakaguchi A. Dense cerebellopontine epidermoid cyst . Surg Neurol . 1981;17:172-177.Crossref 18. Davidson D, Ouchi T, Steiner RE. NMR imaging of congenital intracranial germinal layer neoplasms . Neuroradiology . 1985;27:301-303.Crossref 19. Latack JT, Kartush JM, Kemink JL. Epidermoidomas of the cerebellopontine angle and temporal bone: CT and MR aspects . Radiology . 1985;157:361-366.Crossref 20. Olson JJ, Beck DW, Crawford SC, Menezes AH. Comparative evaluation of intracranial epidermoid tumors with computed tomography and magnetic resonance imaging . Neurosurgery . 1987;21:357-360.Crossref 21. Vion-Drury J, Vincentelli F, Jiddane M, et al. MR imaging of epidermoid cysts . Neuroradiology . 1987;29:333-338.Crossref 22. Rooney MS, Poon PY, Wortzman G. Magnetic resonance imaging of intracranial epidermoids: report of two cases . J Can Assoc Radiol . 1987;38:283-287. 23. Kortman KE, Bradley WG. Supratentorial neoplasms . In: Stark DD, Bradley WG, eds. Magnetic Resonance Imaging . St Louis, Mo: CV Mosby Co; 1988:405. 24. Brooks ML, Jolesz FA, Patz S. MRI of pulsatile CSF motion within arachnoid cysts . Magn Reson Imaging . 1988;6:575-584.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Jul 1, 1990

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