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DOI: 10.1055/s-2004-44886
© Georg Thieme Verlag Stuttgart · New York
Giant Intradiploic Epidermoid Cyst of the Occipital Bone
Gigantische intradiploische Epidermoidzyste des Os occipitalePublication History
Publication Date:
24 February 2004 (online)
![](https://www.thieme-connect.de/media/zblneurochir/200401/lookinside/thumbnails/10.1055-s-2004-44886-1.jpg)
Abstract
A rare case of giant intradiploic epidermoid cyst of the occipital bone with large intracranial extension in the posterior fossa is described. The lesion was discovered when the patient presented with headache and subcutaneous swelling in the occipital region, in the absence of signs of neurological involvement.
CT scan showed extensive destruction of the occipital bone, mainly of the inner table, up to the foramen magnum. On MRI the lesion was hypointense in T1 and hyperintense in T2-weighted images; signal inhomogeneity was due to cellular debris and cholesterol crystals. The enhancing rim due to the thickened dura confirmed the extradural location. Complete removal of the cyst was easily accomplished despite its large size.
We found only 3 documented cases in the literature of giant intradiploic infratentorial epidermoid cysts, none of which was studied by MRI. The radiological features and differential diagnosis are discussed.
Zusammenfassung
Es wird der seltene Fall einer riesenhaften intradiploischen Epidermoidzyste des Os occipitale mit großer intrakranieller Ausdehnung in die hintere Schädelgrube beschrieben. Zur Entdeckung der Läsion führten Kopfschmerzen und eine subkutane Schwellung okzipital bei fehlenden neurologischen Ausfällen. Die Computertomographie konnte die extensive Destruktion des Okzipitalknochens gut darstellen, insbesondere der Tabula interna bis hinunter zum Foramen magnum. Im Kernspintomogramm war die Läsion hypointens in T1- und hyperintens in T2-gewichteten Bildern. Wegen des zellulären Debris und der Cholesterolkristalle bestanden Signalinhomogenitäten. Der Kontrastmittel aufnehmende Rand der verdickten Dura bestätigte die extradurale Lokalisation. Trotz ihrer ausgedehnten Größe war die komplette Entfernung der Epidermoidzyste leicht durchführbar. Aus der Literatur konnten nur drei Fälle von riesenhafter intradiploischer Epidermoidzyste im intratentoriellen Bereich gesammelt werden, von denen kein Bericht MRT-Befunde enthielt. Die radiologischen Charakteristika und die Differenzialdiagnosen werden diskutiert.
Key words
Epidermoid cyst - skull tumor - occipital bone
Schlüsselwörter
Epidermoidzyste - Kalottentumor - Os occipitale
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Prof. Francesco Maiuri
Dipartimento di Scienze Neurologiche
Cattedra di Neurochirurgia
Facoltà di Medicina e Chirurgia
Università Federico II
Via S. Pansini, 5
80131-Napoli
Italy
Phone: +39/0 81-7 46 25 76
Email: frmaiuri@unina.it