Caruso G, Germanó A, Caffo M, Belvedere M, La Torre D, Tomasello F
Neurosurgical Clinic, University of Messina School of Medicine, Messina,
Pediatr Neurosurg. 1998 Oct;29(4):203-7. doi: 10.1159/000028722.
Epidermoid cysts (ECs) are rare developmental lesions occurring anywhere along the central nervous system. Usually affecting adult patients, the occurrence of supratentorial dorsal cistern ECs has been reported in only 1 certain case of pediatric age. An additional pediatric case is presented. An 11-year-old boy had an 8-year history of petit mal seizures. Neurologic examination on admission was negative. T1-weighted magnetic resonance images demonstrated homogenous, hypointense, intradural, extracerebral, right frontal, precentral, parasagittal mass with relatively high signal intensity on T2-weighted images. The lesion was completely removed using a microneurosurgical technique with special care taken with regard to the adjacent nervous and vascular structures. Histologically, an EC was diagnosed. The patient had no recurrence for 2 years and seizures were significantly reduced. This case suggests the need to include ECs in the differential diagnosis of intradural supratentorial extracerebral lesions in childhood.
表皮样囊肿(ECs)是罕见的发育性病变,可发生于中枢神经系统的任何部位。通常影响成年患者,幕上背侧脑池表皮样囊肿仅在1例儿科患者中被报道。现报告另外1例儿科病例。一名11岁男孩有8年的失神发作病史。入院时神经系统检查为阴性。T1加权磁共振成像显示均匀、低信号、硬膜内、脑外、右额叶、中央前回、矢状旁肿块,在T2加权图像上信号强度相对较高。采用显微神经外科技术将病变完全切除,对相邻的神经和血管结构给予特别小心的处理。组织学诊断为表皮样囊肿。患者2年无复发,癫痫发作明显减少。该病例提示在儿童硬膜内幕上脑外病变的鉴别诊断中需要考虑表皮样囊肿。