Recurrence of epidermoid cyst in the third ventricle. Case report

The authors present the case of a 34-year-old man. The patients was admitted for the second time in the clinic. A year before an epidermoid cyst of the third ventricle, obstructing the two foramen Monroe and causing acute hydrocephaly, was surgically removed. In the operative intervention a cerebral fenestration of the lateral cerebral ventricle was performed and the epidermoid cyst was totally extirpated through the right foramen Monroe under operative microscope. The patient was discharged in excellent state, without complaints and neurological symptoms. The patient received attacks of severe headaches, staggering gate and double vision two months before his second admission. The neurological examination revealed paresis of left nervus abducens, staggering gait and pronounced psychic symptoms. The computed tomography of the brain revealed cystic formation, 3.4 cm in diameter, in the front part of the third cerebral ventricle. The intervention was performed after preoperative management of the patient and a cystic tumor with the histologic characteristics of an epidermoid cyst was totally extirpated under operative microscope, using the same approach as in the first operation. The patient was discharged in good state without complaints and no abnormalities detected in the neurological status.