Incidence and Surgical Outcome of the Intracranial Epidermoid Cyst at Punjab Institute of Neurosciences Lahore, Pakistan

Authors

  • Tariq Imran Khokhar Punjab Institute of Neurosciences, Lahore, Department of Neurosurgery Unit III, Pakistan
  • Muhammad Naveed Majeed Punjab Institute of Neurosciences, Lahore, Department of Neurosurgery Unit III, Pakistan
  • Khawar Anwar Punjab Institute of Neurosciences, Lahore, Department of Neurosurgery Unit III, Pakistan
  • Asif Bashir Punjab Institute of Neurosciences, Lahore, Department of Neurosurgery Unit III, Pakistan

DOI:

https://doi.org/10.36552/pjns.v26i2.693

Keywords:

Cranial Nerves, Epidermoid Cyst, Cerebellopontine Angle

Abstract

Objectives:  The incidence and microsurgical outcomes of intracranial epidermoid cysts in the Department of Neurosurgery III, Punjab Institute of Neurosciences (PINS), Lahore, Pakistan, are described in this case series.

Materials and Methods:  This study was a data analysis of a case series of 15 patients (mean age, 40 years) of both gender with intracranial epidermoid cysts who had microsurgical surgical excision over five years.

Results:  This study comprised 11 (73.3%) male and 4 (26.7%) female patients, 11 (73.3%) cases were infratentorial and 4 (26.7%) cases were in supratentorial region. The epidermoid was located in the CP angle in 11 (73.3%) patients, 3 (20%) in the midline supra sellar region, and 1 (6.66%) in the frontotemporal region. The presenting complaints were mainly headache in 11 (73.33%), cranial nerve palsy and cerebellar signs in 8 (53.3%) patients, Trigeminal neuralgia in 3 (20%) patients, Fits and hydrocephalus in 2 (13.3%) patients. There were 14 (93.3%) patients with GTR (gross total resection), 1 (6.6%) patients STR (subtotal resection). According to Karnofsky's performance scoring (KPS), 3 (20%) patients improved, 11 (73.3%) patients had the same KPS, and 1 (6.6%) patient had a lower KPS.

Conclusion:  The epidermoid cysts in the brain are usually found in the infratentorial region rather than the supratentorial region. Infratentorial lesions typically cause cranial nerve deficits, whereas the supratentorial area symptom is a headache.

References

Alvord Jr EC. Growth rates of epidermoid tumors. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 1977; 2 (5): 367-70.

Shear BM, Jin L, Zhang Y, David WB, Fomchenko EI, Erson-Omay EZ, et al. Extent of resection of epidermoid tumors and risk of recurrence: case report and meta-analysis. Journal of Neurosurgery. 2019; 133 (2): 291-301.

Oommen A, Govindan J, Peroor DS, Azeez CR, Rashmi R, Jalal MJA. Giant occipital intradiploic epidermoid cyst. Asian Journal of Neurosurgery. 2018; 13 (2): 514.

Akar Z, Tanriover N, Tuzgen S, Kafadar AM, Kuday C. Surgical treatment of intracranial epidermoid tumors. Neurologia Medico-chirurgica. 2003; 43 (6): 275-81.

Tuchman A, Platt A, Winer J, Pham M, Giannotta S, Zada G. Endoscopic-assisted resection of intracranial epidermoid tumors. World Neurosurgery. 2014; 82 (3-4): 450-4.

Safavi-Abbasi S, Di Rocco F, Bambakidis N, Talley MC, Gharabaghi A, Luedemann W, et al. Has the management of epidermoid tumors of the cerebellopontine angle improved? A surgical synopsis of the past and present. Skull Base. 2008; 18 (02): 085-98.

Niikawa S, Hara A, Zhang W, Sakai N, Yamada H, Shimokawa K. Proliferative assessment of craniopharyngioma and epidermoid by nucleolar organizer region staining. Child's Nervous System. 1992; 8 (8): 453-6.

Samii M, Tatagiba M, Piquer J, Carvalho GA. Surgical treatment of epidermoid cysts of the cerebellopontine angle. Journal of Neurosurgery. 1996; 84 (1): 14-9.

Mohanty A, Venkatrama SK, Rao BR, Chandramouli BA, Jayakumar PN, Das BS. Experience with cerebellopontine angle epidermoids. Neurosurgery. 1997; 40 (1): 24-30.

Ya?argil MG, Abernathey CD, Sarioglu AÇ. Microneurosurgical treatment of intracranial dermoid and epidermoid tumors. Neurosurgery. 1989; 24 (4): 561-7.

Talacchi A, Sala F, Alessandrini F, Turazzi S, Bricolo A. Assessment and surgical management of posterior fossa epidermoid tumors: report of 28 cases. Neurosurgery. 1998; 42 (2): 242-51.

Kobata H, Kondo A, Iwasaki K. Cerebellopontine angle epidermoids presenting with cranial nerve hyperactive dysfunction: pathogenesis and long-term surgical results in 30 patients. Neurosurgery. 2002; 50 (2): 276-86.

Berger MS, Wilson CB. Epidermoid cysts of the posterior fossa. Journal of Neurosurgery. 1985; 62 (2): 214-9.

Aboud E, Abolfotoh M, Pravdenkova S, Gokoglu A, Gokden M, Al-Mefty O. Giant intracranial epidermoids: is total removal feasible? Journal of Neurosurgery. 2015; 122 (4): 743-56.

Bonneville F, Savatovsky J, Chiras J. Imaging of cerebellopontine angle lesions: an update. Part 1: enhancing extra-axial lesions. European Radiology. 2007; 17 (10): 2472-82.

Nagasawa D, Yew A, Safaee M, Fong B, Gopen Q, Parsa AT, et al. Clinical characteristics and diagnostic imaging of epidermoid tumors. Journal of Clinical Neuroscience. 2011; 18 (9): 1158-62.

Schiefer TK, Link MJ. Epidermoids of the cerebellopontine angle: a 20-year experience. Surgical Neurology. 2008; 70 (6): 584-90.

Reddy MP, Jiacheng S, Xunning H, Zhanlong M. Intracranial epidermoid cyst: characteristics, appearance, diagnosis, treatment and prognosis. Sci Lett. 2015; 3: 102-10.

Czernicki T, Kunert P, Nowak A, Wojciechowski J, Marchel A. Epidermoid cysts of the cerebellopontine angle: Clinical features and treatment outcomes. Neurologia i Neurochirurgia Polska. 2016; 50 (2): 75-82.

Iaconetta G, Carvalho GA, Vorkapic P, Samii M. Intracerebral epidermoid tumor: a case report and review of the literature. Surgical Neurology. 2001; 55 (4): 218-22.

Lopes M, Capelle L, Duffau H, Kujas M, Sichez J, Van Effenterre R, et al. Surgery of intracranial epidermoid cysts. Report of 44 patients and review of the literature. Neuro-chirurgie. 2002; 48 (1): 5-13.

Downloads

Published

2022-07-17