Epidermoid cyst - intracranial

Case contributed by Professor Ali Hekmatnia

Presentation

Seizure and headache

Patient Data

Age: 55 years
Gender: Female

MRI demonstrating typical appearance of a massive epidermoid cyst located in middle cranial fossa with extension to right cerebellopontine angel and prepontine and ambient and quadrigeminal and suprasellar cisterns and complete encasement of basilar and right vertebral arteries and anterior displacement of right MCA. Mass effect on right lateral ventricle and brain stem is noted too. It is hyperintense on T2 weighted images and DWI, and hypointense on T1WI and ADC map.

Case Discussion

Epidermoid cysts are extra-axial slow-growing benign tumors that insinuate between brain structures, their intra-axial or intradiploic location are rare. Fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted MRI sequences help to differentiate them from arachnoid cyst.

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