Summary
The authors report the case of a 67-year-old woman with primary micro-invasive squamous cell carcinoma located in the lateral ventricle and originating from an epidermoid cyst. Radiological and histological features of the neoplasm are described and the relevant literature is studied briefly.
Two consecutive surgical specimens were studied by light microscopy. In the histological sections of the subtotally removed material of the first operation, the cyst wall was layered by epithelium — the same as expected in an epidermoid cyst — and showed foci with mild to moderate dysplastic changes. Theses changes did not reach up to the degree of a carcinoma. However, because the cyst could not be resected totally, the possibility of a squamous cell carcinoma was considered in the differential diagnosis. In the present case, the diagnosis was firmly established in a second surgical specimen obtained ten months after the first operation. Now, the tumour proved to be a primary squamous cell carcinoma, which exhibited severe dysplastic changes.
Primary squamous cell carcinoma of brain is extremely rare. To our knowledge, only 20 such tumours with pre-existing epidermoid cyst have been reported in the central nervous system. The intriguing observation in this case is a three year recurrence free survival following the subtotal removal of the malignant neoplasm at the second surgery, without postoperative radiotherapy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abramson R, Morawetz RB, Schlitt M (1989) Multiple complications from an intracranial epidermoid cyst: case report and literature review. Neurosurgery 24: 574–578
Acciari N, Padovani R, Foschini MP, Giulioni M, Finizio FS (1993) Intracranial squamous cell carcinoma arising in an epidermoid cyst. Br J Neurosurg 7: 565–569
Davidson SE, Small JM (1960) Malignant change in an intracranial epidermoid. J Neurol Neurosurg Psychiatry 23: 176–178
Delangre T, Hemet C, Tayot J, Vaschalde Y, Augustin P (1992) Malignant degeneration of epidermoid cyst of the posterior cranial fossa. Diagnostic value of magnetic resonance imaging. Rev Neurol 148: 55–57
Dubois PJ, Sage M, Luther JS, Burger PC, Heinz ER, Drayer BP (1981) Malignant change in an intracranial epidermoid cyst: case report. J Comput Assist Tomogr 5: 433–435
Ernst P (1912) Häufung dysontogenetischer Bildungen am Zentralnervensystem. Verh Dtsch Pathol Ges 15: 226–230
Fox E, South EA (1965) Squamous cell carcinoma developing in an intracranial epidermoid cyst (cholesteatoma). J Neurol Neurosurg Psychiatry 28: 276–281
Garcia CA, McGarry PA, Rodriguez F (1981) Primary intracranial squamous cell carcinoma of the right cerebellopontine angle. J Neurosurg 54: 824–828
Goldman AS, Gandy SE (1987) Squamous cell carcinoma as a late complication of intraventricular epidermoid cyst. J Neurosurg 66: 618–620
Henkel HG (1951) Besondere Formen bösartiger Erkrankungen der weichen Hirnhäute. Verch Dtsch Ges Pathol 35: 185–188
Hug O (1942) Krebsbildung aus einem pialen Epidermoid. Virchows Arch (Pathol Anat) 308: 679–689
Kahn EA (1969) Metastatic tumors of the brain. In: Khan EA, Crosby EC, Schneider RC,et al (eds) Correlative neurosurgery, 2nd Ed. Thomas, Springfield, pp 225–226
Knorr JR, Ragland RL, Smith TW, Davidson RI, Keller JD (1991) Squamous carcinoma arising in a cerebellopontine angle epidermoid: CT and MR findings. AJNR 12: 1182–1184
Kobayashi T, Kuchiwaki H, Inao S, Nakashima S (1993) A squamous cell carcinoma originated from intracranial dermoid cyst. Neurochirurgica 36: 26–29
Komjatszegi S (1964) Malignant transformation of a basal leptomeningeal epidermoid. Stud Cercet Neurol 9: 501–504
Kömpf D, Menges HW (1977) Maligne Entartung eines parapontinen Epidermoids. Akutes conus-cauda Syndrom infolge meningealer Aussat. Acta Neurochir (Wien) 39: 81–90
Landers JW, Danielski JJ (1960) Malignant intracranial epidermoid cyst. Report of a case with leptomeningeal spread. Arc Pathol 70: 419–423
Lewis AJ, Cooper PW, Kassel EE, Schwartz ML (1983) Squamous cell carcinoma arising in a suprasellar epidermoid cyst. J Neurosurg 59: 538–541
Lombardo FP, Hertford DE, Tan LK, Kazam E, Ramirez DE, Arellaro E (1995) Epidermoid cyst of the liver complicated by microscopic squamous cell carcinoma: CT, ultrasound, and pathology. J Comput Assist Tomogr 19: 131–134
Nishio S, Takeshita I, Morioka T, Fukui M (1995) Primary intracranial squamous cell carcinomas — report of two cases. Neurosurgery 37 (2): 329–332
Nosaka Y, Nagao S, Tabuchi K, Nishimoto A (1979) Primary intracranial epidermoid carcinoma. A case report. J Neurosurg 50: 830–833
Russell DS, Rubinstein LJ (1989) Dermoid and epidermoid cysts. In: Pathology of tumours of the nervous system, 5th Ed. Edward Arnold, London, pp 690–695
Tognetti F, Lanzino G, Manetto V, Calbucci F (1991) Intracranial squamous cell carcinoma arising in the remnant of extirpated epidermoid cyst. Br J Neurosurg 5: 303–305
Yamanaka A, Hinohara S, Hashimoto T (1955) Primary diffuse carcinomatosis of the spinal meninges accompanied by a cancerous epidermal cyst of the base of the brain. Gan 46: 274–276
Yanai Y, Tsuji R, Ohmori S, Tatara N, Kubota S, Nagashima C (1985) Malignant change in an intradiploic epidermoid. Report of a case and review of the literature. Neurosurgery 16: 252–256
Yasargil MG, Abernathey CD, Sarioğlu AÇ (1989) Microneurosurgical treatment of intracranial dermoid and epidermoid tumors. Neurosurgery 24: 561–567
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bayindir, C., Balak, N. & Karasu, A. Micro-invasive squamous cell carcinoma arising in a pre-existing intraventricular epidermoid cyst. Acta neurochir 138, 1008–1012 (1996). https://doi.org/10.1007/BF01411292
Issue Date:
DOI: https://doi.org/10.1007/BF01411292