[C-P angle epidermoid carcinoma: a case report]

The patient, a 39-year-old man, underwent initial surgery for total removal of a left C-P angle tumor histologically diagnosed as epidermoid carcinoma. Postoperative irradiation therapy was administered over the whole brain and spinal cord, 50 Gy and 20 Gy respectively. The patient was then released without symptoms. 15 months later, he was readmitted for paraparesis and urinary retention. CT scan revealed no tumor recurrence in the intracranial area but did show intraspinal cyst of the lower thoracic level. After cyst-subarachnoid shunt, severe acute hydrocephalus was shown on CT scan. His general condition progressively deteriorated. Ten days after the shunt operation, he died of systemic bleeding tendency and cachexia. During surgery, the authors obtained dark yellowish fluid from the intraspinal cyst. Gene survey of the specimen from the cyst wall disclosed abnormality. It is important in the diagnosis of primary intracranial epidermoid carcinoma that we rule out the existence of extracranial cancer and direct invasion through the dura. Though epidermoid carcinoma can be fatal, radiotherapy was an efficacious treatment in the present case, as well as in three other reported cases.