Intracranial epidermoid cyst

Intracranial Epidermoid Cyst - MRI scans 10.5 years apart

Intracranial epidermoid cysts, also known as epidermoid tumors, are rare, benign (non-cancerous) brain tumors that account for approximately 1% of all brain tumors. They are slow-growing masses that develop from ectodermal cells, which are cells related to the skin and nervous system. These cysts are typically filled with keratin, a protein found in skin and hair, and other substances secreted by the cells lining the cyst. Intracranial epidermoid cysts are considered congenital, meaning they are present at birth, though they may not be diagnosed until later in life due to their slow growth and often asymptomatic nature.

Symptoms

The symptoms of an intracranial epidermoid cyst can vary greatly depending on its size and location within the brain. Common symptoms include headaches, seizures, and neurological deficits such as weakness or numbness in parts of the body, problems with balance, or changes in hearing or vision. In some cases, the cyst may become infected, leading to symptoms such as fever and increased intracranial pressure.

Diagnosis

Diagnosis of an intracranial epidermoid cyst typically involves imaging studies. Magnetic resonance imaging (MRI) is the preferred method as it provides detailed images of the brain, allowing for the identification of the cyst's characteristic appearance and its distinction from other types of brain tumors. Computed tomography (CT) scans may also be used, especially if MRI is not available.

Treatment

The primary treatment for intracranial epidermoid cysts is surgical removal. The goal of surgery is to remove as much of the cyst as possible without damaging surrounding brain tissue. Complete removal can be challenging due to the cyst's adherence to critical brain structures and the risk of neurological damage. In cases where total removal is not possible, partial resection may be performed to alleviate symptoms, with close follow-up to monitor for cyst growth. There is a risk of cyst recurrence, especially if the cyst lining is not completely removed.

Prognosis

The prognosis for individuals with intracranial epidermoid cysts is generally good, especially if the cyst can be completely removed. Surgical complications, such as infection or damage to surrounding brain tissue, can occur but are relatively rare. Long-term follow-up is often recommended to monitor for recurrence.

Epidemiology

Intracranial epidermoid cysts are most commonly diagnosed in adults between the ages of 20 and 40, but they can occur at any age. There is no known gender or racial predilection.

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