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Intradiploic epidermoid cyst

Case contributed by Huda B. Gharbia
Diagnosis probable

Presentation

left scalp swelling, headache.

Patient Data

Age: 45 years
Gender: Female

Intradiploic, well defined, expansile, osteolytic lesion in left frontotemporal bones, causes bone remodeling and erosion of both inner and outer table of skull, with small internal foci of calcifications.

mri

Well defined exta-axial, intradiploic cystic space occupying lesion in left fronto-temporal bones, appears heterogenous in T1W and hyperintense in T2Wimages, heterogenously hyperintense in FLAIR sequences, not enhanced post contrast, shows restricted diffusion in DW/ADC sequences.

causes mass effect, buckling adjacent brain parenchyma, the adjoining enhanced dura is pushed medially, and midline shifting to right side.

causes bone remodeling abutting left orbital roof.

Case Discussion

Expansile, osteolytic, intradiploic cystic lesion in skull bone, restricted diffusion suggestive intradiploic epidermoid cyst.

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