White epidermoid

Case contributed by Dr Janki Trivedi

Presentation

Memory loss and personality changes.

Patient Data

Age: 75
Gender: Male
MRI

T2 hyperintense and mixed T1 hyperintense extradural lesion measuring 4.7 cm in the right posterior fossa that demonstrates high DWI signal with areas of true diffusion restriction. 

Case Discussion

The patient proceeded to craniotomy and resection of the mass. 

Histopathology

MACROSCOPIC DESCRIPTION: An aggregate of tan yellow/light pink soft tissue 11x8x6mm.

MICROSCOPIC DESCRIPTION: Sections show a cyst wall lining with a thin layer of stratified squamous epithelium including a granular cell layer, with bland nuclear features and surface keratinization. The wall is fibrous with areas of infiltration by mononuclear chronic inflammatory cells with foreign body type multinucleate giant cells, in association with cholesterol clefts. There is no brain tissue identified. There is no evidence of malignancy.

DIAGNOSIS: Epidermal cyst.

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Case information

rID: 61476
Published: 7th Jul 2018
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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