Boumeriem Khaoula, Lahfidi Amal, Zineb Izi, Kettani Najwa Ech Cherif, Fikri Meryem, Touarsa Firdaous, Jiddane Mohamed
Neuroradiology Department, Ibn Sina University Hospital Center, Rabat, Morocco.
Radiol Case Rep. 2025 Mar 15;20(6):2662-2665. doi: 10.1016/j.radcr.2025.02.047. eCollection 2025 Jun.
Epidermoid cysts are rare intracranial lesions comprising approximately 1% of all brain tumors, with petrous apex involvement accounting for 4%-9% of cases. These congenital lesions arise from ectodermal remnants during neural tube closure, while acquired cases may result from trauma or chronic middle ear pathology. Clinical presentation is variable and depends on the lesion's location and impact on surrounding neurovascular structures, with cranial nerve dysfunction being the most common symptom. Imaging plays a crucial role in diagnosis, with diffusion-weighted MRI distinguishing epidermoid cysts from other lesions such as arachnoid cysts and cholesterol granulomas. Management remains challenging due to their proximity to critical structures; complete surgical excision minimizes recurrence but may increase morbidity, while subtotal resection requires long-term follow-up. We report the case of a 40-year-old female patient who presented with a history of progressive hearing loss and facial paralysis, in whom an epidermoid cyst of the petrous apex was diagnosed.
表皮样囊肿是罕见的颅内病变，约占所有脑肿瘤的1%，岩尖受累占病例的4%-9%。这些先天性病变起源于神经管闭合期间的外胚层残余物，而获得性病例可能由创伤或慢性中耳病变引起。临床表现多样，取决于病变的位置及其对周围神经血管结构的影响，其中颅神经功能障碍是最常见的症状。影像学在诊断中起着关键作用，弥散加权磁共振成像（MRI）可将表皮样囊肿与其他病变如蛛网膜囊肿和胆固醇肉芽肿区分开来。由于它们靠近关键结构，治疗仍然具有挑战性；完整的手术切除可将复发风险降至最低，但可能增加发病率，而次全切除则需要长期随访。我们报告了一例40岁女性患者，她有渐进性听力丧失和面瘫病史，经诊断为岩尖表皮样囊肿。
