Microsurgical Resection of Intracranial Dermoid and Epidermoid Tumors

Abstract

Objective: To Ascertain the outcome of microsurgical resection of intracranial dermoid and epidermoid tumors.
Materials and Methods: This prospective study was carried out in Neurosurgical Department, Lady Reading Hospital (LRH) Peshawar and followed for 3 years after microsurgical resection. All the patients with suspected intracranial Dermoid and epidermoid tumors (IDETs) on imaging study pre-operatively and later confirmed
postoperatively (after histopathology) were enrolled. Patients having recurrent tumor, opting for nonsurgical management and those deem unfit for surgery were not included in the study.
Results: 27 patients were included in the study with 12 (44.4%) males and 15 (56.6%) female. Age of the patients rangefrom 11 to 58 years.Mean age was 38.6 years. Epidermoid tumors were 19 (70.3%) in number and dermoid 8 (29.7%) in number. The most common presentation was increased intracranial pressure (ICP) and cranial
nerve deficit. The lesion was located in infratentorial location in 15 (56.6%) patients, 12(44.4%) were supratentorialy located. Gross total removal (GTR) was performed in 21 (77.8%) patients, while in six patients (22.2%) subtotal removal (STR) was attempted. 1 (3.7%) patient died while 2 (7.4%) patients had permanent morbidity post operatively, all other patients (89%) improved. Recurrence occurred in 9.5% of GTR patients while in STR patients, 33.3% patients were noted with increase in residual tumor on neuroimaging.
Conclusion: Microsurgical resection with GTR is possible for most IDET and gives good results with minimalcomplications.