Kalfas Fotios, Ramanathan Dinesh, Mai Jeffrey, Schwartz Seth, Sekhar Laligam N
Department of Neurological Surgery, University of Washington, Seattle, USA.
Asian J Neurosurg. 2012 Apr;7(2):93-7. doi: 10.4103/1793-5482.98656.
Epidermoid cysts are histologically benign, slow-growing congenital neoplasms of the central nervous system that may arise from retained ectodermal implants. The epidermoid lesions are generally caused during the 3(rd) to 5(th) week of gestation by an incomplete cleavage of the neural tissue from the cutaneous ectoderm, though it can also happen later in life due to introduction of skin elements by skin puncture, trauma or surgery. We present this unique case of a petromastoid epidermoid cyst associated with ipsilateral cerebellar abscesses, presenting 20 years after a penetrating trauma to the external auditory canal. Radical excision of both lesions and revision of the previous fistulous tract was performed. We present the diagnostic challenge and the operative treatment of this unique case, which to our knowledge is the first where an epidermoid cyst and an adjacent brain abscess occurred as a result of a single traumatic event.
表皮样囊肿是组织学上良性、生长缓慢的中枢神经系统先天性肿瘤,可能起源于残留的外胚层植入物。表皮样病变通常在妊娠第3至5周时,由于神经组织与皮肤外胚层的不完全分离而形成,不过在生命后期,由于皮肤穿刺、创伤或手术引入皮肤成分,也可能发生。我们报告了这一独特病例,一名岩乳突表皮样囊肿合并同侧小脑脓肿,在外耳道穿透性创伤20年后出现。对两个病变进行了根治性切除,并对先前的瘘管进行了修复。我们介绍了这一独特病例的诊断挑战和手术治疗,据我们所知,这是首例因单一创伤事件导致表皮样囊肿和相邻脑脓肿的病例。