Nickl Robert C, Nickl Vera, Schindehütte Magnus, Monoranu Camelia-Maria, Ernestus Ralf-Ingo, Löhr Mario
Departments of1Neurosurgery.
2Pathology, and.
J Neurosurg Case Lessons. 2022 Oct 17;4(16). doi: 10.3171/CASE2254.
Malignant progression of intracranial dermoid cysts into squamous cell carcinoma is extremely rare with only three reports published so far. Intracranial dermoid cysts are uncommon benign tumors lined by stratified squamous epithelium of embryonic ectodermal origin.
Here, the authors present the case of a 64-year-old female with a recurrent temporal dermoid cyst. After surgery for the recurrent dermoid cyst, once in the early 1990s and another 16 years later, the patient presented with headache and nausea due to hydrocephalus. After implantation of a ventriculoperitoneal shunt, she deteriorated rapidly and died only 60 days after admission. Autopsy revealed malignant transformation of the epithelial lining of the dermoid cyst into a squamous cell carcinoma resulting in neoplastic meningiosis and intraperitoneal tumor spread along a previously implanted ventriculoperitoneal shunt.
Malignant transformation should be considered in patients with dermoid cyst who show new leptomeningeal contrast enhancement. In the case of hydrocephalus, alternatives to peritoneal shunting should be considered.
颅内皮样囊肿恶变为鳞状细胞癌极为罕见，迄今为止仅有三篇相关报道。颅内皮样囊肿是一种少见的良性肿瘤，由胚胎外胚层来源的复层鳞状上皮衬里。
在此，作者报告一例64岁复发性颞部皮样囊肿女性患者的病例。该患者分别于20世纪90年代初及16年后接受了复发性皮样囊肿手术，之后因脑积水出现头痛和恶心症状。在植入脑室腹腔分流管后，她病情迅速恶化，入院仅60天后死亡。尸检显示皮样囊肿的上皮衬里恶变为鳞状细胞癌，导致肿瘤性软脑膜炎以及肿瘤沿先前植入的脑室腹腔分流管向腹腔扩散。
对于出现新的软脑膜对比增强的皮样囊肿患者，应考虑恶性转化的可能。对于脑积水患者，应考虑采用腹腔分流以外的其他治疗方法。
