Interhemispheric epidermoid

Case contributed by Dr Prashant Mudgal

Diagnosis probable

Presentation

Young male presented with headache and history of epilepsy

Patient Data

Age: 17 years

Gender: Male

From the case: Interhemispheric epidermoid

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Axial non-contrast

A well defined low density lesion of near CSF attenuation extra axial lesion noted in the right parietal parafalcine region. The lesion is dura based and shows no significant post contrast enhancement. There is foci of peripheral coarse calcifications noted in the lesion.

Case Discussion

Epidermoids are benign congenital lesions and constitute less than 2 % of all intracranial tumors. Like dermoids and dermal sinus, epidermoid cysts arise from the ectodermal rest cells. Epidermoids grow slowly and become symptomatic during the later in adulthood, unlike dermoids, which are faster growing and can be symptomatic earlier in life.

In this case, the imaging features are most likely suggestive of interhemispheric epidermoid cyst. This could be confirmed with MRI, which is unfortunately not available.