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Surgical Treatment of an Endolymphatic Sac Tumor
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Cerebellopontine angle endodermal cyst presenting with hemifacial spasm.

Prasanna Karki1, Manoj Bohara, Hajime Yonezawa

  • 1Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.

Brain Tumor Pathology
|June 7, 2011
PubMed
Summary

Intracranial endodermal cysts causing hemifacial spasm (HFS) are rare. Surgical removal of a cerebellopontine angle cyst relieved a patient's HFS symptoms.

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Area of Science:

  • Neurosurgery
  • Neuropathology
  • Cystic lesions

Background:

  • Intracranial endodermal cysts are uncommon, and their association with hemifacial spasm (HFS) is exceptionally rare.
  • Hemifacial spasm is typically caused by vascular compression of cranial nerves.

Observation:

  • A 56-year-old male presented with a 6-month history of right-sided hemifacial spasm.
  • Imaging revealed a right cerebellopontine angle (CPA) endodermal cyst compressing cranial nerves VII and VIII.

Findings:

  • Microscopic examination confirmed the cyst wall's epithelial lining, positive for CEA, EMA, and CK8, characteristic of an endodermal cyst.
  • Surgical resection of the cyst via a right lateral suboccipital approach was performed, with total removal of cyst contents and subtotal removal of the cyst wall.

Implications:

  • This case highlights the possibility of intracranial endodermal cysts as a cause of hemifacial spasm.
  • Successful surgical management resulted in complete resolution of the patient's hemifacial spasm, suggesting a causal relationship.