Incidental Interhemispheric Epidermoid Cyst; Two Case Reports

Öz

Epidermoid cysts are benign cystic lesions of ectodermal origin. Malignant transformation is very rare. They constitute approximately 0.2-1.8% of primary intracranial tumors. These cysts, which are mostly asymptomatic, are usually detected incidentally. They are most commonly located in the cerebollopontine corner. Interhemispheric location has been reported very rarely in the literature. The treatment of interhemispheric epidermoid cysts is surgical, and knowing the size, localization and relationship of the cyst with surrounding structures is of great importance in determining the surgical approach. A classification system for interhemispheric cysts has been developed in the literature to standardize the surgical approach. In this article, CT and MRI findings of an interhemispherically located epidermoid cyst detected incidentally are presented in two cases.

Anahtar Kelimeler

• Epidermoid Cyst
• CT
• MRI

Rastlantısal İnterhemisferik Epidermoid Kist; İki Olgu Sunumu

Öz

GİRİŞ Epidermoid kistler ektodermal orijinli, benign kistik lezyonlardır. Malign transformasyon çok nadirdir. Primer intrakraniyal tümörlerin yaklaşık %0,2-1,8’ini oluştururlar. Çoğunlukla asemptomatik olan bu kistler genellikle insidental olarak saptanırlar. En sık serebollopontin köşede yerleşim gösterirler. İnterhemisferik yerleşim literatürde oldukça nadir bildirilmiştir. İnterhemisferik epidermoid kistlerin tedavisi cerrahi olup cerrahi yaklaşımı belirlemede kistin boyutunu, lokalizasyonunu ve çevre yapılarla ilişkisini bilmek büyük önem taşımaktadır. Literatürde cerrahi yaklaşımı standardize etmek amacıyla interhemisferik kistlere yönelik bir sınıflandırma sistemi geliştirilmiştir. Bu yazıda insidental olarak saptanan interhemisferik yerleşimli epidermoid kiste ait BT ve MR bulguları iki olgu üzerinden sunulmuştur.

Anahtar Kelimeler

• Epidermoid kist
• BT
• MR

Kaynakça

1. 1. Osborn AG, Preece MT. Intracranialcysts: radiologic-pathologic correlation and imaging approach. Radiology. 2006; 239:650-664
2. 2. Dhananjaya I Bhat, B Indira Devi, A Raghunath, Sampath Somanna, BA Chandramouli. Interhemispheric epidermoids - An uncommon lesion in an uncommon location: A report of 15 cases. NeurologyIndia. 59 (1): 82
3. 3. deSouza CE, deSouza R, da Costa S et-al. Cerebellopontine angle epidermoid cysts: a report on 30 cases. J. Neurol. Neurosurg. Psychiatr. 1989; 52:986-990
4. 4. Chen CY, Wong JS, Hsieh SC et-al. İntracranial epidermoid cyst with hemorrhage: MR imaging findings. AJNR Am J Neuroradiol. 2006; 27:427-429
5. 5. Bahattin Hakyemez, Müfit Parlak. İntrakranyal kistik ya da nekrotik kitlelerde proton MR spektroskopinin klinik tanıya katkısı. 2002; 8:182-186
6. 6. Agarwal V, Vijayan A, Velho V, Mally R. Pearl in interhemispheric fissure: A rare phenomenon. Asian journal of neurosurgery 2012 ;7: 229-232
7. 7. Das KK, Honna RM, Attri G, Khatri D, Gosal JS, Dixit P, Singh S, Verma PK, Maurya VP, Bhaisora KS, Sardhara J, Mehrotra A, Srivastava AK, Jaiswal AK, Behari S. A Single-Center Surgical Experience of Interhemispheric Epidermoids and Proposal of a New Radiological Classification. World Neurosurg. 2020;141:e606-e614.