Yoshizato K, Kai Y, Kuratsu J, Ushio Y
Department of Neurosurgery, Kumamoto University Medical School, Japan.
Surg Neurol. 1996 Jun;45(6):537-40. doi: 10.1016/0090-3019(95)00470-x.
The incidence of intracranial epidermoid cysts is between 0.2% to 1.8% of all brain tumors. They usually occur in the cerebellopontine angle or parasellar region. Intramedullary epidermoid cyst is rare and only nine cases have been previously reported.
A 69-year-old woman had progressive left hemiparesis for 2 years. Computed tomography scanning and magnetic resonance imaging (MRI) revealed that there was a cystic tumor in the pons that was compressing the brain stem. A part of the tumor cyst wall and the content of the cyst were surgically removed by right subtemporal transtentorial approach. The histologic diagnosis was epidermoid cyst. After the surgery, the left hemiparesis was improved and there was no sign of the tumor growth by MRI.
The outcome of the previous cases with radical tumor resection was poor compared with the present case in which only a part of the cyst wall and the content were removed. Therefore, radical removal of the whole tumor may not be necessary for intramedullary epidermoid cyst of the brain stem.
颅内表皮样囊肿的发病率占所有脑肿瘤的0.2%至1.8%。它们通常发生在桥小脑角或鞍旁区域。髓内表皮样囊肿罕见，此前仅有9例报道。
一名69岁女性渐进性左侧偏瘫2年。计算机断层扫描和磁共振成像（MRI）显示脑桥有一个囊性肿瘤压迫脑干。通过右侧颞下入路经小脑幕手术切除部分肿瘤囊壁和囊内容物。组织学诊断为表皮样囊肿。术后，左侧偏瘫症状改善，MRI显示无肿瘤生长迹象。
与本病例仅切除部分囊壁和囊内容物相比，既往行肿瘤根治性切除的病例预后较差。因此，对于脑干髓内表皮样囊肿，可能无需彻底切除整个肿瘤。
