Isozumi T, Tsuji A, Nakasu S, Matsuda M, Handa J
Department of Neurosurgery, Shiga University of Medical Science.
No Shinkei Geka. 1995 May;23(5):423-7.
We report a case of a 35-month-old Japanese boy harboring a dermoid cyst in the region of the anterior fontanelle, which is rarely reported among Japanese. A small soft subcutaneous mass was noticed in the mid-frontal region at the age of 6 months. On admission, a soft, nontender round mass (2.5cm in diameter) was located over the anterior fontanelle. Transillumination was negative. Neurological examination yielded normal findings. MRI showed a well-circumscribed mass, which was slightly hypointense on T1W1 and hyperintense on T2W1. Midsagittal MRI showed no intracranial extension. At operation, a well-encapsulated mass was found beneath the pericranium, which was easily dissected from the underlying dura mater and removed. The tumor contained caseous material and several hairs. Microscopically, the cyst wall consisted of connective tissues lined by stratified squamous epithelium. Sebaceous glands and hair follicles were found in the subepithelial layer. It is important to confirm preoperatively whether or not the extracranial mass extends into the intracranial cavity. For this purpose, midsagittal or coronal MRI seems to be most useful.
我们报告一例35个月大的日本男孩，其前囟区域存在皮样囊肿，这在日本人中鲜有报道。该男孩6个月大时在额中部区域发现一个小的皮下软肿块。入院时，在前囟上方有一个柔软、无压痛的圆形肿块（直径2.5厘米）。透光试验为阴性。神经学检查结果正常。磁共振成像（MRI）显示一个边界清晰的肿块，在T1加权像（T1W1）上略呈低信号，在T2加权像（T2W1）上呈高信号。矢状位MRI显示无颅内延伸。手术时，在颅骨膜下发现一个包膜完整的肿块，很容易从下方的硬脑膜上分离并切除。肿瘤含有干酪样物质和几根毛发。显微镜下，囊肿壁由分层鳞状上皮衬里的结缔组织组成。上皮下层可见皮脂腺和毛囊。术前确认颅外肿块是否延伸至颅内腔很重要。为此，矢状位或冠状位MRI似乎最有用。
