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[Primary intracranial malignant epidermoid--case report]

T Fuse1, T Takagi, S Mizuno

  • 1Department of Neurosurgery, Nagoya City Higashi General Hospital, Japan.

No to Shinkei = Brain and Nerve
|October 1, 1995
PubMed
Summary

Malignant intracranial epidermoid tumors are rare. This case highlights how Magnetic Resonance (MR) imaging can precisely differentiate malignant epidermoid cysts from benign ones, aiding diagnosis.

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Area of Science:

  • Neurology
  • Oncology
  • Radiology

Background:

  • Intracranial epidermoid tumors are rare neoplasms.
  • Malignant transformation of epidermoid cysts is exceptionally uncommon.

Observation:

  • A 74-year-old woman presented with a primary intracranial malignant epidermoid tumor in the parapontine region.
  • CT scan revealed two components: a low-density benign prepontine lesion and a malignant enhanced cerebellopontine angle lesion.
  • MRI demonstrated distinct signal intensities and enhancement patterns differentiating the benign and malignant portions.

Findings:

  • Benign epidermoid portions showed low T1 and high T2 signal intensity.
  • Malignant portions exhibited iso-signal intensity on T1, marked enhancement, and heterogeneous T2 signal.
  • Contrast enhancement on CT, atypical for benign epidermoid, suggested malignant degeneration.

Implications:

  • Distinguishing between benign and malignant epidermoid cysts is crucial for appropriate treatment planning.
  • Magnetic Resonance (MR) imaging offers superior precision in differentiating these entities compared to CT.
  • This case underscores the importance of advanced imaging techniques in diagnosing rare intracranial tumors.

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