Ochoa Adalberto, Saenz Amparo, Argañaraz Romina, Mantese Beatriz
Division of Pediatric Neurosurgery, Hospital de Pediatría Juan P. Garrahan, Combate de los Pozos 1881, 1245, Buenos Aires, Argentina.
Childs Nerv Syst. 2020 Dec;36(12):3141-3146. doi: 10.1007/s00381-020-04646-y. Epub 2020 May 2.
Intracranial dermoid cysts are benign congenital slow growing masses. They account for less than 1% of all primary intracranial lesions. They can be asymptomatic and appear incidentally on brain images. However, there are some dermoid cysts that, depending on the location, can cause a variety of symptoms, especially if they compress vital structures. Rupture of intracranial dermoid cysts is relatively uncommon; the incidence is 0.18%. Dermoid cyst in children appears in the posterior fossa, while in adults is more common to find them in the sellar, temporal, and frontobasal region. The Meckel's cave is not a frequent location for these lesions and there are only a few cases in the adult population reported in the literature. We presented a 12-year-old patient with a dermoid cyst in the Meckel's cave who first presented with symptoms of a ruptured cyst but eventually evolved with a trigeminal neuralgia. We decided to do a transzygomatic approach and a middle fossa pealing to locate and excise the lesion. After surgery, the patient resolved the symptoms. Surgery is recommended in symptomatic lesions although surgical decision-making should consider the region where the cyst is located to achieve a safe, maximal resection without adding any further damage.
颅内皮样囊肿是良性先天性生长缓慢的肿块。它们占所有原发性颅内病变的比例不到1%。它们可以无症状，在脑部影像检查时偶然发现。然而，有些皮样囊肿根据其位置不同，可能会引起各种症状，尤其是当它们压迫重要结构时。颅内皮样囊肿破裂相对少见，发生率为0.18%。儿童的皮样囊肿多发生于后颅窝，而在成人中，皮样囊肿更常见于鞍区、颞叶和额底部区域。梅克尔腔不是这些病变的常见部位，文献中报道的成年患者病例较少。我们报告了一名12岁患有梅克尔腔内皮样囊肿的患者，该患者最初表现为囊肿破裂的症状，但最终发展为三叉神经痛。我们决定采用经颧弓入路和中颅窝剥离术来定位并切除病变。术后，患者症状缓解。对于有症状的病变，建议进行手术治疗，不过手术决策应考虑囊肿所在区域，以实现安全、最大程度的切除，同时避免造成进一步损伤。
