Department of Neurosurgery, the Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong Province, 266003, China.
Cerebellum. 2011 Sep;10(3):536-9. doi: 10.1007/s12311-011-0268-z.
Almost all intracranial dermoid cysts typically display low-density lesions on plain computerized tomography (CT) scans due to abundant lipids content. CT hyperattenuating dermoid cyst (CHADC) is very uncommon with only nine case reports in the literature update, which occurs exclusively in the posterior fossa. Moreover, CHADC with mural nodule is exceptionally rare, and only one such case was documented previously. Here, we report a new case of cerebellar CHADC with mural nodule in a 14-year-old male patient who presented with a 4-week history of dull headache and 5-day history of gait disturbance. With an average attenuation value of 89.9 Hounsfield units on CT scans, the lesion mainly displayed T1 hyperintensity, T2 hypointensity, and FLAIR hypointensity on magnetic resonance imaging. The patient underwent lesion gross total resection and symptomatic improvement, and final pathology was consistent with dermoid cyst. For further clarifying the mechanism of unusual CT hyperdensity, we sampled the cystic content and quantified its protein, calcium, and cholesterol, and our result suggested the high protein, high calcium, and low lipids in contents was the main mechanism of increased CT attenuation for CHADC.
几乎所有颅内皮样囊肿在 CT 平扫上均因富含脂质而呈现为低密度病变。CT 高信号皮样囊肿（CHADC）非常罕见，文献更新中仅有 9 例报告，且仅发生在后颅窝。此外，壁结节型 CHADC 极为罕见，此前仅报道过 1 例。在此，我们报告 1 例新的小脑 CHADC 伴壁结节，患者为 14 岁男性，表现为 4 周头痛和 5 天步态障碍病史。CT 扫描平均 CT 值为 89.9HU，病变在磁共振成像上主要表现为 T1 高信号、T2 低信号和 FLAIR 低信号。患者行病变大体全切除，症状改善，最终病理与皮样囊肿一致。为进一步阐明异常 CT 高密度的机制，我们采集了囊内容物并对其蛋白、钙和胆固醇进行了定量分析，结果提示囊内容物中高蛋白、高钙和低脂质是 CHADC 增强 CT 衰减的主要机制。
