Brainstem epidermoid cyst: An update.

Area of Science:

• Neurology
• Neurosurgery
• Developmental Biology

Background:

• Epidermoid tumors constitute 1-2% of intracranial neoplasms.
• Commonly found in the cerebellopontine angle and parasellar regions, they are rare in the brainstem.
• These slow-growing tumors develop from embryonic epidermal cell remnants.

Purpose of the Study:

• To report an unusual case of an intrinsic brainstem epidermoid cyst.
• To highlight diagnostic imaging findings.
• To discuss treatment challenges and outcomes.

Main Methods:

• Case presentation of a 5-year-old girl with a brainstem epidermoid cyst.
• Review of diagnostic imaging, emphasizing diffusion-weighted imaging.
• Discussion of surgical resection strategies and their limitations.

Main Results:

• The patient presented with an intrinsic brainstem epidermoid cyst containing milky, liquefied material.
• Diffusion-weighted imaging proved definitive for diagnosis.
• Complete capsule resection was technically difficult due to adherence to the brainstem, posing a risk of neurological deficits.

Conclusions:

• Intrinsic brainstem epidermoid cysts are rare but can occur.
• Diffusion-weighted imaging is crucial for accurate diagnosis.
• Surgical management requires careful consideration of the risks associated with complete capsule resection from the brainstem.