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双侧侧脑室表皮样囊肿:一例报告

Bilateral lateral ventricular epidermoid cyst: A case report.

作者信息

Asefa Bizuayehu, Zenebe Eyob, Feleke Ermias, Furi Worku, Solomon Henock

机构信息

PO Box: 9086, Addis Ababa University, School of Medicine, Depart of Surgery, Neurosurgery Unit, Ethiopia.

PO Box: 9086, Addis Ababa University, School of Medicine, Depart of Surgery, Neurosurgery Unit, Ethiopia.

出版信息

Int J Surg Case Rep. 2025 Sep 15;136:111944. doi: 10.1016/j.ijscr.2025.111944.

Abstract

INTRODUCTION

Epidermoid cysts are benign inclusion cysts that arise from ectopically displaced ectodermal tissue. Intraventricular epidermoid cysts are uncommon, and involvement of the bilateral lateral ventricles is rarely reported. Computed tomography (CT) scans typically show well-localized, hypodense lesions. These cysts are slightly hyperintense to cerebrospinal fluid (CSF) on both T1 and T2 magnetic resonance imaging (MRI) sequences.

CASE PRESENTATION

We report a 17-year-old male diagnosed with bilateral lateral ventricular epidermoid cysts after presenting with a four-year history of episodic generalized tonic-clonic seizures and recurrent throbbing global headache. He had surgery, and histopathology confirmed an epidermoid cyst. Postoperatively, the patient experienced symptom improvement.

DISCUSSION

Intracranial epidermoid cysts are benign, accounting for 0.2 %-1.8 % of intracranial tumors. Lateral ventricular epidermoids present with obstructive hydrocephalus and signs and symptoms of increased intracranial pressure. Pathological analysis reveals a pearly white tumor composed of simple squamous cells with abundant laminated and compacted keratin and positivity for epithelial membrane antigen. Both microscopic and endoscopic techniques can be used for the resection of lateral ventricular epidermoid cysts.

CONCLUSION

Lateral ventricular epidermoids are rare benign lesions. Clinical features include symptoms of increased intracranial pressure, such as headache, vomiting, and altered mentation. MRI is the diagnostic imaging modality of choice. Complete surgical resection is curative, with rare reports of recurrence after subtotal resection. Follow-up is crucial to monitor for recurrence and other associated complications.

摘要

引言

表皮样囊肿是由异位的外胚层组织形成的良性包涵囊肿。脑室内表皮样囊肿并不常见,双侧侧脑室受累的情况鲜有报道。计算机断层扫描(CT)通常显示病变定位良好、密度减低。在T1和T2磁共振成像(MRI)序列上,这些囊肿相对于脑脊液(CSF)呈轻度高信号。

病例报告

我们报告一名17岁男性,因有四年发作性全身强直阵挛性癫痫和反复发作的搏动性全头痛病史,被诊断为双侧侧脑室表皮样囊肿。他接受了手术,组织病理学证实为表皮样囊肿。术后,患者症状有所改善。

讨论

颅内表皮样囊肿是良性的,占颅内肿瘤的0.2%-1.8%。侧脑室表皮样囊肿表现为梗阻性脑积水和颅内压升高的体征和症状。病理分析显示为珍珠白色肿瘤,由具有丰富层状和致密角蛋白的单层鳞状细胞组成,上皮膜抗原呈阳性。显微镜和内镜技术均可用于侧脑室表皮样囊肿的切除。

结论

侧脑室表皮样囊肿是罕见的良性病变。临床特征包括颅内压升高的症状,如头痛、呕吐和意识改变。MRI是首选的诊断成像方式。完整的手术切除可治愈,次全切除后复发的报道罕见。随访对于监测复发和其他相关并发症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24fa/12495248/efdc1c1e1153/gr1.jpg

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