PDF(Pubmed)
Abstract：
Intracranial epidermoid cysts are benign, slow-growing congenital tumors of ectodermal origin. They are rare embryonal benign cystic masses with an incidence rate of approximately 0.04%-0.6% of intracranial tumors. Computed tomography (CT) and magnetic resonance imaging (MRI) are fundamental diagnostic tools providing valuable information for surgical management. We reported a 59-year-old male patient with right limb weakness twelve hours prior to admission, slurred speech, and paresis of the facial nerve. Based on history taking, physical examination, and radiology examinations, we concluded a diagnosis of non-communicated hydrocephalus due to a right cerebellar intra-axial tumor with a suspicion of low-grade glioma (Pylocitic Astrocytoma). CT and MRI in intracranial epidermoid cysts are fundamental diagnostic tools for diagnosing and obtaining helpful information for surgical planning. Intracranial epidermoid cysts appear as lobulated lesions filling and expanding CSF spaces and exerting a gradual mass effect, insinuating between structures and encasing adjacent nerves and vessels. In this case, we noted a hypodense lesion with irregular calcifications and well-defined on the right cerebellar region measuring 6.15 × 5.47 × 5.7 cm, surrounded by a hypodense image suggesting an intra-axial mass suspected of low-grade glioma with a differential diagnosis of brain abscess. The hypointense lesion on the T1WI sequence found in the MRI examination, with no significant contrast enhancement and restricted diffusion area on DWI, was one of the notable features described in the epidermoid cyst. Intracranial epidermoid cyst rarely occurs in the intracranial, resulting in many symptoms in this case, which should be diagnosed and treated promptly. Imaging aids in proper diagnosis and provides more valuable information for further treatment.
摘要：
颅内表皮样囊肿是良性的，外胚层起源的缓慢生长的先天性肿瘤。它们是罕见的胚胎性良性囊性肿块，发生率约为颅内肿瘤的0.04％-0.6％。计算机断层扫描（CT）和磁共振成像（MRI）是基本的诊断工具，为手术管理提供有价值的信息。我们报告了一名59岁的男性患者，在入院前12小时患有右肢体无力，含糊不清的讲话，和面神经麻痹.根据历史，体检,和放射学检查，我们的结论是诊断为由于右小脑轴内肿瘤,并怀疑是低级别神经胶质瘤(尿囊性星形细胞瘤)所致的非交通性脑积水.颅内表皮样囊肿的CT和MRI是诊断和获得手术计划有用信息的基本诊断工具。颅内表皮样囊肿表现为分叶病变填充和扩大脑脊液空间，并逐渐产生肿块效应。暗示结构之间并包裹相邻的神经和血管。在这种情况下,我们注意到在右小脑区测量6.15×5.47×5.7cm的低密度病变伴有不规则钙化，并且轮廓清晰。周围是低密度图像，提示怀疑有低度神经胶质瘤的轴内肿块，并有脑脓肿的鉴别诊断。在MRI检查中发现的T1WI序列上的低信号性病变，在DWI上没有明显的对比度增强和限制扩散区域，是表皮样囊肿中描述的显著特点之一。颅内表皮样囊肿很少发生在颅内，在这种情况下导致许多症状，应及时诊断和治疗。成像有助于正确诊断，并为进一步治疗提供更有价值的信息。
