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Ruptured dermoid cyst in the Meckel’s cave presenting with trigeminal neuralgia in a pediatric patient: a case report

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Abstract

Intracranial dermoid cysts are benign congenital slow growing masses. They account for less than 1% of all primary intracranial lesions. They can be asymptomatic and appear incidentally on brain images. However, there are some dermoid cysts that, depending on the location, can cause a variety of symptoms, especially if they compress vital structures. Rupture of intracranial dermoid cysts is relatively uncommon; the incidence is 0.18%. Dermoid cyst in children appears in the posterior fossa, while in adults is more common to find them in the sellar, temporal, and frontobasal region. The Meckel’s cave is not a frequent location for these lesions and there are only a few cases in the adult population reported in the literature. We presented a 12-year-old patient with a dermoid cyst in the Meckel’s cave who first presented with symptoms of a ruptured cyst but eventually evolved with a trigeminal neuralgia. We decided to do a transzygomatic approach and a middle fossa pealing to locate and excise the lesion. After surgery, the patient resolved the symptoms. Surgery is recommended in symptomatic lesions although surgical decision-making should consider the region where the cyst is located to achieve a safe, maximal resection without adding any further damage.

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery, Hospital de Pediatría Juan P. Garrahan, Combate de los Pozos 1881, 1245, Buenos Aires, Argentina

    Adalberto Ochoa, Amparo Saenz, Romina Argañaraz & Beatriz Mantese

Authors
  1. Adalberto Ochoa
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  2. Amparo Saenz
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  3. Romina Argañaraz
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  4. Beatriz Mantese
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Contributions

All authors contributed to the study conception and design. The bibliographic research, summary of the case, and edition of images were carried out by Adalberto Ochoa. The first draft of the manuscript was made by Adalberto Ochoa and Amparo Saenz, and the rest of the authors commented and made contributions to it. All authors read and approved the final manuscript.

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Correspondence to Adalberto Ochoa.

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The authors declare that they have no conflict of interest.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Garrahan’s Pediatric Hospital.

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The patient gave consent to use his information and images for research proposes.

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Ochoa, A., Saenz, A., Argañaraz, R. et al. Ruptured dermoid cyst in the Meckel’s cave presenting with trigeminal neuralgia in a pediatric patient: a case report. Childs Nerv Syst 36, 3141–3146 (2020). https://doi.org/10.1007/s00381-020-04646-y

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  • DOI: https://doi.org/10.1007/s00381-020-04646-y

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