Microsurgical Technique for Resection of a Cerebellopontine Angle Epidermoid Tumor

Epidermoid tumors are slow-growing, benign, congenital lesions.¹ They commonly arise in the cerebellopontine angle, fourth ventricle, suprasellar region, or spinal cord.² Symptoms may include hearing loss, facial pain, and headaches. The management options include observation or surgical resection. If the patient has symptoms, surgical resection is the treatment option of choice with the goal of gross total resection. In Video 1, we discuss the microsurgical technique for the resection of a right cerebellopontine angle epidermoid tumor. A 22-year-old male patient presented with chronic headache, decreased right-sided hearing, right facial pain, and right facial twitching. Magnetic resonance imaging revealed the characteristic finding of an epidermoid tumor, which appeared as isointense on T1 and hyperintense on T2 with diffusion-weighted imaging. The patient was taken to the operating room, and a retrosigmoid craniotomy was performed on the basis of the transverse and sigmoid sinuses. The tumor capsule was opened, and the tumor was decompressed by removing the internal components consisting of epithelial keratin and cholesterol crystals, allowing for a gross total resection to be achieved. The patient's postoperative computed tomography scan showed no residual tumor, and the patient was discharged on postoperative day 1 in stable condition.