Karagöz Güzey Feyza, Bas N Serdar, Sencer Altay, Emel Erhan, Hamamcioglu M Kemal, Ozkan Nezih, Hepgul Kemal, Aycan Abdurrahman
Department of Neurosurgery, Vakif Gureba Training Hospital, Istanbul, Turkey.
Pediatr Neurosurg. 2007;43(4):323-6. doi: 10.1159/000103315.
Dermoid cysts are uncommon tumors, and posterior fossa dermoid cysts may rarely cause abscess formation or formation of daughter abscesses within the cerebellum. At present, there are only 16 cases with posterior fossa dermoid cysts causing cerebellar abscesses reported in the literature. Two cases, 22 and 14 months old, with posterior fossa dermoid cysts and dermal sinus causing multiple cerebellar abscesses are reported. In the first one, there was also marked hydrocephalus. Retrospective examination of the patients revealed pinpoint-sized dimples in their suboccipital regions. Both patients were treated with antibiotics and underwent posterior fossa surgery. In the patient with marked hydrocephalus, ventriculoperitoneal shunting was performed after treatment of the infection. Both patients were neurologically normal, and there were no complaints, except a light learning difficulty in the patient with ventriculoperitoneal shunting, 133 and 34 months after surgery, respectively. Early detection of congenital dermal abnormalities along the craniospinal axis by routine examination of newborns is highly important before development of serious complications. Because surgery is the only effective treatment modality for these lesions, radical excision should be performed in all cases to avoid tumor recurrence. However, subtotal excision may be performed in selected cases, because the cyst capsule may adhere firmly to vital structures.
皮样囊肿是罕见的肿瘤，后颅窝皮样囊肿很少会导致脓肿形成或在小脑内形成子脓肿。目前，文献中仅报道了16例后颅窝皮样囊肿导致小脑脓肿的病例。本文报道了2例分别为22个月和14个月大的患儿，患有后颅窝皮样囊肿和皮样窦，导致多发性小脑脓肿。第一例患儿还伴有明显的脑积水。对这些患儿进行回顾性检查发现，他们枕下区域有针尖大小的酒窝状凹陷。两名患儿均接受了抗生素治疗并进行了后颅窝手术。对于有明显脑积水的患儿，在感染得到治疗后进行了脑室腹腔分流术。两名患儿术后神经功能均正常，术后分别133个月和34个月时，除了接受脑室腹腔分流术的患儿有轻微学习困难外，均无其他不适主诉。在严重并发症发生之前，通过对新生儿进行常规检查早期发现沿颅脊柱轴的先天性皮肤异常非常重要。由于手术是治疗这些病变的唯一有效方式，所有病例均应进行根治性切除以避免肿瘤复发。然而，在某些特定病例中可能需要进行次全切除，因为囊肿包膜可能会与重要结构紧密粘连。
