Intradiploic epidermoid cyst of the skull

Abstract

Authors describe a giant intradiploic epidermoid cyst of the cranial vault with massive intra- and extracranial extension and analyze the clinicopathological, imaging features and treatment of these lesions in the light of the most important published data. A 38-years old male patient with a history of chronic headache reported a painless subcutaneous swelling 4 months ago on the right frontoparietal scalp. CT and MRI evaluation revealed a large well-defined extracerebral mass in the frontoparietal scalp with destruction of both the inner and outer tables of the bone. The patient underwent a total microsurgical resection of the tumor and the cranial defect produced by the resection of the space-occupaying lesion was repaired with titanium wire mesh and methyl methacrylate cranioplasty. The histological examination has shown a cystic structure lined by squamous epithelium and containing laminated keratin material, aspects that are suggesting a epidermoid cyst. The patient post-operative course was uneventful, without any neurological deficit and was discharged after 48 hours of hospitalisation in a good medical condition. The review of the literature shows that the parietal bone location for intradiploic epidermoid tumors in rare. Complete surgical resection represent the gold standard of treatment, and no adjuvant therapy is needed. Recent advances in diagnostic imaging and treatment of these lesions are reviewed.

Keywords

• dermoid
• epidermoid
• intracranial tumor
• radical removal
• skull tumor