Fuse T, Takagi T, Mizuno S, Yamada K
Department of Neurosurgery, Nagoya City Higashi General Hospital, Japan.
No To Shinkei. 1995 Oct;47(10):997-1001.
Intracranial malignant epidermoid is uncommon. We report a case of a 74-year-old woman with a primary intracranial malignant epidermoid in the parapontine region. The tumor was visualized as two components (a low-density benign prepontine lesion and a malignant enhanced cerebellopontine angle lesion) on CT scan. On MRI, the benign portion demonstrated low-signal intensity on T1 weighted images and markedly increased heterogeneous signal intensity on T2 weighted images, while the malignant portion showed iso-signal intensity on T1 weighted images that was markedly enhanced and heterogeneous signal intensity on T2 weighted images. Lack of contrast enhancement is a typical finding in benign epidermoid, although rim enhancement has been described in a few cases. In our patient, the contrast enhancement on CT scan in the otherwise typical epidermoid cyst suggested malignant degeneration. Using MR imaging, we could distinguish malignant epidermoid from benign epidermoid cyst more precisely.
颅内恶性表皮样囊肿并不常见。我们报告一例74岁女性,其桥脑旁区域存在原发性颅内恶性表皮样囊肿。在CT扫描中,肿瘤表现为两个部分(桥脑前低密度良性病变和恶性强化的小脑桥脑角病变)。在MRI上,良性部分在T1加权图像上呈低信号强度,在T2加权图像上信号强度明显增加且不均匀,而恶性部分在T1加权图像上呈等信号强度,明显强化,在T2加权图像上信号强度不均匀。无强化是良性表皮样囊肿的典型表现,尽管少数病例有边缘强化的描述。在我们的患者中,在其他方面典型的表皮样囊肿CT扫描上的强化提示恶性退变。通过磁共振成像,我们能够更精确地区分恶性表皮样囊肿和良性表皮样囊肿。