Trigeminal neuralgia revealing an epidermoid cyst impinging on the Vth cranial nerve: A case report

Intracranial epidermoid cysts, also referred to as intracranial primary cholesteatomas, are uncommon, benign tumors characterized by slow, linear growth patterns akin to normal epidermal tissue. They typically become symptomatic around age 43, with a slight female predominance, and are most frequently located in the cerebellopontine angle. This summary presents the case of a 62-year-old woman suffering from paroxysmal excruciating pain of the right hemiface, indicative of trigeminal neuralgia, linked to an intracranial epidermoid cyst in the cerebellopontine angle. Radiological assessment, through magnetic resonance imaging, was instrumental in identifying the cyst. Total surgery resection is the most effective treatment, but it can be challenging due to tumor adherence to important neurovascular structures, therefore responsible for an incomplete removal of the proliferative capsule causing a higher risk of recurrence. The case also raises questions about treatment options, as the patient opted against surgical intervention. Managing intracranial epidermoid cysts requires a careful weighing of potential benefits against associated risks.