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Transtentorial epidermoid cysts

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Summary

Epidermoid cysts may occur simultaneously above and below the tentorium. Eleven patients with involvement of both infra- and supra-tentorial cisterns are presented. In two cases the epidermoid, located mainly in the cerebello-pontine angle, spread into the middle cranial fossa; in three the epidermoid extended from the parasellar cisterns to the posterior cranial fossa; in six patients the epidermoid, enlarging the tentorial notch, occupied extensively both cranial fossae.

The surgical approach was influenced both by the experience of the surgeon and by the main extension of the epidermoid. Total removal was feasible in two patients only but only one of the eleven patients had a recurrence of the epidermoid. The long term results appear to be unrelated to the size of the epidermoid and to the choice of approach.

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References

  1. Albanese V, Tomasello F, Picozzi P, Sampaolo S, Spadaro A (1982) Paramedian hourglass epidermoid extending above and below the tentorium. Surg Neurol 18: 356–363

    PubMed  Google Scholar 

  2. Alpers BJ (1939) Cerebral epidermoids (cholesteatomas). Am J Surg 43: 55–65

    Google Scholar 

  3. Bailey P (1924) Further observations on pearly tumours. Arch Surg 8: 524–534

    Google Scholar 

  4. Berger MS, Wilson CB (1985) Epidermoid cysts of the posterior fossa. J Neurosurg 62: 214–219

    PubMed  Google Scholar 

  5. Black HA (1943) Intracranial epidermoids occurring simultaneously below and above the tentorium. Arch Neurol Psychiat 49: 214–222

    Google Scholar 

  6. Braun IF, Naidich TP, Leeds NE, Koslow M, Zimmerman HM, Chase NE (1977) Dense intracranial epidermoid tumors. Radiology 122: 717–719

    PubMed  Google Scholar 

  7. Chambers AA, Lukin RR, Tomisck TA (1977) Cranial epidermoid tumors: diagnosis by computed tomography. Neurosurgery 1: 276–280

    PubMed  Google Scholar 

  8. Chiasserini A, Chiasserini A Jr (1955) Epidermoidi e dermoidi del nevrasse. Chir Ital 10: 81–114

    Google Scholar 

  9. Cushing H (1932) Intracranial tumours: notes upon a series of two thousand verified cases with surgical mortality percentages pertaining thereto. Charles C Thomas, Springfield, Ill., pp 99–102

    Google Scholar 

  10. Davidson HD, Ouchi T, Steiner RE (1985) NMR imaging of congenital intracranial germinal layer neoplasms. Neuroradiology 27: 301–303

    PubMed  Google Scholar 

  11. Davis KR, Roberson GH, Taveras JM, New PJF, Trevor R (1976) Diagnosis of epidermoid tumours by computed tomography. Radiology 119: 347–353

    PubMed  Google Scholar 

  12. Dee RH, Kishore PRS, Young HF (1980) Radiological evaluation of cerebellopontine angle epidermoid tumors. Surg Neurol 13: 293–296

    PubMed  Google Scholar 

  13. Derome PJ, Guiot G (1979) Surgical approaches to sphenoidal and clivus areas. In: Krayenbühl Het al (eds) Advances and technical standards in neurosurgery, vol 6. Springer, Wien New York, pp 102–136

    Google Scholar 

  14. de Souza CE, de Souza R, Da Costa S, Sperling N, Yoon TH, Abdelhamid MM, Sharma RR, Goel A (1989) Cerebellopontineangle epidermoid cysts: a report on 30 cases. J Neurol Neurosurg Psychiatry 52: 986–990

    PubMed  Google Scholar 

  15. Drayer BP, Rosenbaum AE, Maroon JC, Bank WO, Woodford JE (1977) Posterior fossa extraaxial cyst: diagnosis with metrizamide CT cisternography. AJR 128: 431–436

    PubMed  Google Scholar 

  16. Dunn RC, Archer CA, Rapport RL, Looi LM (1981) Unusual CT-dense posterior fossa epidermoid cyst. J Neurosurg 55: 654–656

    PubMed  Google Scholar 

  17. Elster AD (1988) Extra-axial neoplasms. Epidermoids. In: Hurley RA (ed) Cranial magnetic resonance imaging. New York, pp 137–142

  18. Fein JM, Lipow K, Taati F, Lansem T (1981) Epidermoid tumour of the cerebellopontine angle: diagnostic value of computed tomographic metrizamide cisternography. Neurosurgery 9: 179–182

    PubMed  Google Scholar 

  19. Fleming JFR, Botterell EH (1959) Cranial dermoid and epidermoid tumors. Surg Gynecol Obstet 109: 403–411

    PubMed  Google Scholar 

  20. Gagliardi FM, Vagnozzi R, Caruso R, Delfini R (1980) Epidermoids of the cerebellopontine angle (cpa): usefulness of CT scan. Acta Neurochir (Wien) 54: 271–281

    Google Scholar 

  21. Grant FC, Austin GM (1950) Epidermoids: clinical evaluation and surgical results. J Neurosurg 7: 190–198

    PubMed  Google Scholar 

  22. Gros C, Vlahovitch B (1957) Les cholestéatomes de la fente de Bichat à expansion intraventriculaire et sous-tentorielle. Neurochirurgie 3: 327–329

    Google Scholar 

  23. Guidetti B, Gagliardi FM (1977) Epidermoid and dermoid cysts. Clinical evaluation and late surgical results. J Neurosurg 47: 12–18

    PubMed  Google Scholar 

  24. Hamel E, Frowein RA, Karimi-Nejad A (1980) Intracranial intradural epidermoids and dermoids. Surgical results of 38 cases. Neurosurg Rev 3: 215–219

    PubMed  Google Scholar 

  25. Hanamura T, Amano K, Hatanaka H, Tsukagoshi H (1978) A case of epidermoid of the fourth ventricle. J Neurol 219: 145–149

    PubMed  Google Scholar 

  26. Handa J, Nakano Y, Aii H (1977) CT cisternography with intracranical arachnoidal cysts. Surg Neurol 8: 451–454

    PubMed  Google Scholar 

  27. Hasegawa H, Bitoh S, Nakata M, Fujiwara M, Yasuda H (1981) Intracranial epidermoid mimicking meningioma. Surg Neurol 15: 372–374

    PubMed  Google Scholar 

  28. Hiratsuka H, Okada K, Matsunaga M, Tanaka K, Fukai N, Inaba Y (1984) Diagnosis of epidermoid cysts by metrizamide CT cisternography. Neuroradiology 26: 153–155

    PubMed  Google Scholar 

  29. Imamura Y, Ninchoji T, Nakajima S, Uemura K (1982) Epidermoid tumor in the fourth ventricle, with particular reference to Metrizamide CT cisternography findings. Surg Neurol 18: 444–447

    PubMed  Google Scholar 

  30. Ishikawa M, Kikuchi H, Asato R (1989) Magnetic resonance imaging of the intracranial epidermoid. Acta Neurochir (Wien) 101: 108–111

    Google Scholar 

  31. Ito Y, Kakau M, Kodama T, Matsukada Y (1980) Intracranial high density epidermoid. No Shinkei Geka 8: 645–648

    PubMed  Google Scholar 

  32. Kapila A, Steinbaum S, Chakeres DW (1984) Meckel's cave epidermoid with trigeminal neuralgia. CT findings. J Comput Assist Tomogr 8: 1172–1174

    PubMed  Google Scholar 

  33. Keville FJ, Wise BL (1959) Intracranial epidermoid and dermoid tumors. J Neurosurg 16: 564–569

    PubMed  Google Scholar 

  34. Laster DW, Moody DM, Ball MR (1977) Epidermoid tumors with intraventricular and subarachnoid fat: report of two cases. Am J Roentgenol 128: 504–507

    Google Scholar 

  35. Liguori R (1967) Cisti epidermoidi basilari ad espansione soprae sottotentoriale. Minerva Neurochir 11: 110–114

    PubMed  Google Scholar 

  36. Love JG, Kernohan JW (1936) Dermoid and epidermoid tumors (cholesteatomas of central nervous system. JAMA 107: 1876–1883

    Google Scholar 

  37. Lunardi P, Rizzo A, Guidetti G (1988) Unusual CT-dense transtentorial epidermoid cyst. Neurochirurgia (Stuttg) 31: 219–221

    Google Scholar 

  38. MacCarty CS, Leavens ME, Love JG, Kernohan JW (1959) Dermoid and epidermoid tumors in the central nervous system of adults. Surg Gynecol Obstet 108: 181–198

    Google Scholar 

  39. MacKay IM, Bydder GM, Young IR (1985) MR imaging of central nervous system tumors that do not display increase in T1 o T2. J Comput Assist Tomogr 9: 1055–1061

    PubMed  Google Scholar 

  40. Maiuri F, Donzelli R, Spaziante R, Gallicchio B, Briganti F, De Divitiis E, D'Andrea F (1986) Paramedian hourglass epidermoid cysts extending in the middle and posterior cranial fossa. J Neurosurg Sci 30: 187–196

    PubMed  Google Scholar 

  41. Matsuno H, Rhoton AL, Peace D (1988) Microsurgical anatomy of the posterior fossa cisterns. Neurosurgery 23: 58–80

    PubMed  Google Scholar 

  42. Nagashima C, Takahama M, Sakaguchi A (1982) Dense cerebellopontine epidermoid cyst. Surg Neurol 17: 172–177

    PubMed  Google Scholar 

  43. Netsky MG (1988) Epidermoid tumours. Review of the literature. Surg Neurol 29: 477–483

    PubMed  Google Scholar 

  44. Olivecrona H (1932) On suprasellar cholesteatomas. Brain 55: 122–134

    Google Scholar 

  45. Olson JJ, Beck DW, Crawford SC, Menezes AH (1987) Comparative evaluation of intracranial epidermoid tumors with computed tomography and magnetic resonance imaging. Neurosurgery 21: 357–360

    PubMed  Google Scholar 

  46. Osborne DR (1985) Epidermoid and dermoid tumors: Radiology. In: Wilkins RH, Rengachary SS (eds) Neurosurgery, vol 1. New York, pp 662–667

  47. Peyton WT, Baker AB (1942) Arch Neurol Psychiat 47: 890–917

    Google Scholar 

  48. Reeves DL (1967) Epidermoid (Mixed) tumors of the central nervous system. J Neurosurg 26: 21–24

    PubMed  Google Scholar 

  49. Rosario M, Becker DH, Conley FK (1981) Epidermoid tumors involving the fourth ventricle. Neurosurgery 9: 9–13

    PubMed  Google Scholar 

  50. Rosenbluth PR, Lichtenstein BW (1960) Pearly tumor (epidermoid cholesteatoma) of the brain: clinicopathologic study of two cases. J Neurosurg 17: 35–42

    PubMed  Google Scholar 

  51. Rubin G, Scienza R, Pasqualin A, Rosta L, Da Pian R (1989) Craniocerebral epidermoids and dermoids. Acta Neurochir (Wien) 97: 1–16

    Google Scholar 

  52. Sabin HI, Bordi LT, Symon L (1987) Epidermoid cysts and cholesterol granulomas centered on the posterior fossa: twenty years of diagnosis and management. Neurosurgery 21: 798–805

    PubMed  Google Scholar 

  53. Salazar J, Vaquero J, Saucedo G, Bravo G (1987) Posterior fossa epidermoid cysts. Acta Neurochir (Wien) 85: 34–39

    Google Scholar 

  54. Schraeder PL, Cohen MM, Goldman W (1981) Bilateral internuclear opthalmoplegia associated with fourth ventricular epidermoid tumor. J Neurosurg 54: 403–405

    PubMed  Google Scholar 

  55. Steffey DJ, De Filipp GJ, Spera T, Gabrielsen TO (1988) MR imaging of primary epidermoid tumors. J Comput Assist Tomogr 12: 438–440

    PubMed  Google Scholar 

  56. Symon L (1982) Surgical approaches to the tentorial hiatus. In: Krayenbühl Het al (eds) Advances and technical standards in neurosurgery, vol 9. Springer, Wien New York, pp 69–112

    Google Scholar 

  57. Tampieri D, Melanson D, Ethier R (1989) MR imaging of epidermoid cysts. AJNR 10: 351–356

    PubMed  Google Scholar 

  58. Tytus JS, Pennybacker J (1956) Pearly tumours in relation to the central nervous system. J Neurol Neurosurg Psychiatry 19: 241–259

    Google Scholar 

  59. Valavanis A, Schubiger O, Naidich TP (1987) Clinical imaging of the cerebello-pontine angle. Springer, Berlin Heidelberg New York, p 80

    Google Scholar 

  60. Vion-Dury J, Vincentelli F, Jiddane M, Van Bunnen Y, Rumeau C, Grisoli F, Salamon G (1987) MR imaging of epidermoid cysts. Neuroradiology 29: 333–338

    PubMed  Google Scholar 

  61. Yamakawa K, Shitara N, Genka S, Manaka S, Takakura K (1989) Clinical course and surgical prognosis of 33 cases of intracranial epidermoid tumors. Neurosurgery 24: 568–573

    PubMed  Google Scholar 

  62. Yaşargil MG (1984) Operative anatomy. Subarachnoid cysterns, in microneurosurgery, vol. 1. Thieme, Stuttgart New York, p 14

    Google Scholar 

  63. Yaşargil MG, Abernathey CD, Sarioglu AC (1989) Microneurosurgical treatment of intracranial dermoid and epidermoid tumors. Neurosurgery 24: 561–567

    PubMed  Google Scholar 

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Lunardi, P., Missori, P. Transtentorial epidermoid cysts. Acta neurochir 113, 125–130 (1991). https://doi.org/10.1007/BF01403197

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