Intracranial epidermoid cyst

Case contributed by Khaloud Alghamdi
Diagnosis certain

Presentation

New onset of temporal lobe seizures and epilepsy.

Patient Data

Age: 35 years
Gender: Female

Brain

mri
This study is a stack
Axial
T2
This study is a stack
Coronal
T2
This study is a stack
Axial
T1
This study is a stack
Coronal
T1
This study is a stack
Coronal
T1 IR
This study is a stack
Axial
B1000
This study is a stack
Axial
ADC
This study is a stack
Axial
T1 C+
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Info

Large extra-axial, tumor-like lesion located in left frontotemporal area, expanding the Sylvian fissure with invasion of adjacent parenchyma at the frontal and temporal opercula with lobulated margins, with significant mass effect.

It demonstrates a very thin rim of enhancement post contrast infusion.The signal appearance of the lesion is similar to CSF and in diffusion weighted imaging demonstrates increased signal which is compatible with epidermoid growth.

The lesion demonstrates no evidence of hemorrhage or significant edema however, it is causing significant mass effect on the mesial temporal lobe, there is uncal herniation and incipient midline shift with mild compression of the left lateral ventricle.

Case Discussion

After a subtotal resection of the epidermoid tumor, histopathology confirmed the diagnosis of an epidermoid cyst.

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