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孕期出现的钙化性颅内表皮样囊肿:一例报告

Calcified intracranial epidermoid cyst presented during pregnancy: A case report.

作者信息

Pishdad Parisa, Soltani Amirhossein, Ghanbarzadeh Amirmehdi, Houshi Shakiba, Salimi Mohsen

机构信息

Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran.

Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Radiol Case Rep. 2025 May 15;20(8):3738-3743. doi: 10.1016/j.radcr.2025.04.103. eCollection 2025 Aug.

Abstract

We present the case of a 29-year-old female with a history of an intracranial tumor, initially diagnosed at age 22, who presented during her first pregnancy at 23 weeks with a seizure episode. MRI revealed a nonenhancing mass in the middle cranial fossa with high T1-weighted signal intensity. Despite concerns regarding the potential for eclampsia, the patient was conservatively managed with seizure prophylaxis, and a cesarean section was performed at 38 weeks' gestation. Over the following years, the patient experienced stable imaging findings and mild headaches but later developed worsening symptoms due to mass effect, requiring a Ventriculoperitoneal shunt and subsequent tumor resection. Pathology confirmed the diagnosis of an epidermoid cyst. This case highlights the importance of a multidisciplinary approach to managing intracranial lesions in pregnancy, as early diagnosis and careful coordination between obstetrics, neurology, and neurosurgery teams are crucial to ensuring optimal maternal and fetal outcomes. Additionally, it underscores the need for long-term follow-up in patients with brain lesions during pregnancy, as complications may arise years later, necessitating timely interventions. Notably, this case also demonstrates unique characteristics of an epidermoid cyst with high T1-weighted signal and hyperdensity on CT that remained unchanged over time, favoring the diagnosis of a calcified epidermoid cyst-a rare entity.

摘要

我们报告一例29岁女性病例,该患者有颅内肿瘤病史,最初于22岁时被诊断出,在她23周的首次妊娠期间出现癫痫发作。磁共振成像(MRI)显示中颅窝有一个无强化肿块,T1加权像信号强度高。尽管担心子痫的可能性,但患者通过预防癫痫进行保守治疗,并在妊娠38周时进行了剖宫产。在接下来的几年里,患者的影像学检查结果稳定,仅有轻度头痛,但后来因占位效应症状加重,需要进行脑室腹腔分流术及随后的肿瘤切除术。病理检查确诊为表皮样囊肿。该病例突出了多学科方法在处理妊娠期颅内病变中的重要性,因为早期诊断以及产科、神经科和神经外科团队之间的仔细协调对于确保母婴的最佳结局至关重要。此外,它强调了对妊娠期脑病变患者进行长期随访的必要性,因为并发症可能在数年之后出现,需要及时干预。值得注意的是,该病例还展示了表皮样囊肿的独特特征,即T1加权像信号高且在CT上呈高密度,随时间保持不变,支持钙化表皮样囊肿这一罕见实体的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f58/12144452/1bf5d4a87365/gr1.jpg

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