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Case report: Scattered intraventricular lesions on MRI following epidermoid cyst resection
Michael Städt1, Markus Holtmannspötter1, Alberto Nania2
1Institute of Neuroradiology, Paracelsus Medical University, 90471 Nuremberg, Germany.
Abstract:
Local recurrence after epidermoid cyst surgery is a frequently reported complication, but intraventricular spread after surgery has not yet been described in literature. We present the case of a 61-year-old male patient with steadily progressive headaches after surgical excision of an epidermoid cyst in the right cerebellopontine angle about two months ago. The MRI showed multiple intraventricular FLAIR-hyperintensities with diffusion restriction, suggestive of scattered remnants of the epidermoid cyst. We recommend early postoperative MRI-scans after cranial epidermoid surgery, which should be carefully inspected not only for local remnants but also rare complications like intraventricular spread.
Insights
Intraventricular spread of epidermoid cysts after surgery is a rare complication. Early postoperative MRI scans are crucial for detecting both local remnants and this unusual spread.
Area of Science:
- Neurosurgery
- Neuroradiology
- Neuropathology
Background:
- Epidermoid cysts are congenital tumors often found in the cerebellopontine angle.
- Surgical excision is the primary treatment, but local recurrence is a known complication.
Observation:
- A 61-year-old male presented with progressive headaches two months post-surgery for a right cerebellopontine angle epidermoid cyst.
- Magnetic Resonance Imaging (MRI) revealed multiple intraventricular FLAIR-hyperintensities with diffusion restriction.
Findings:
- The MRI findings suggest scattered remnants of the epidermoid cyst within the ventricles.
- This represents the first reported case of intraventricular spread of an epidermoid cyst after surgical removal.
Implications:
- Postoperative MRI surveillance following cranial epidermoid cyst surgery is essential.
- Radiologists and neurosurgeons should be vigilant for rare complications such as intraventricular spread, not just local recurrence.
