Skip to main content

Advertisement

Log in

Radiotherapy for recurrent intracranial epidermoid cysts without malignant transformation: a single-institution case series

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Introduction

Recurrent intracranial epidermoid cysts may be difficult to address surgically given their proximity to critical neurovascular structures of the skull base. There are emerging reports of using radiotherapy (RT) for the treatment of recurrent epidermoid cysts. Here, we report a case series of adjuvant fractionated external beam RT for recurrent intracranial epidermoid cysts.

Methods

A single-institution review of all recurrent epidermoid cysts treated with adjuvant therapy between 2000 and 2017 was performed.

Results

Eight patients with recurrent epidermoid cysts who underwent adjuvant external beam RT were identified. Average age at initial diagnosis was 42.2 years, and median clinical follow-up after initial diagnosis and RT was 16.4 and 2.9 years, respectively. The median number of surgical resections prior to RT was 3 (range 2–5). Rationale for RT included multiple recurrent disease, rapid recurrence following prior resection, increased risk of further surgical morbidity, and patient preference. Median dose was 50.4 delivered in 1.8 Gy fractions (median 28 fractions). By the date of last follow-up, no patient has demonstrated progression, and there have been no cases of malignant degeneration.

Conclusion

Adjuvant RT should be considered in the context of recurrent epidermoid cysts to decrease the likelihood of further recurrences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Guidetti B, Gagliardi FM (1977) Epidermoid and dermoid cysts. Clinical evaluation and late surgical results. J Neurosurg 47:12–18. https://doi.org/10.3171/jns.1977.47.1.0012

    Article  CAS  PubMed  Google Scholar 

  2. International Agency for Research on Cancer (2016) WHO classification of tumours of the central nervous system, 4th edn. World Health Organization, Geneva

    Google Scholar 

  3. Nagasawa D, Yew A, Safaee M et al (2011) Clinical characteristics and diagnostic imaging of epidermoid tumors. J Clin Neurosci 18:1158–1162. https://doi.org/10.1016/j.jocn.2011.02.008

    Article  PubMed  Google Scholar 

  4. Forghani R, Farb RI, Kiehl T-R, Bernstein M (2007) Fourth ventricle epidermoid tumor: radiologic, intraoperative, and pathologic findings. Radiographics 27:1489–1494. https://doi.org/10.1148/rg.275075011

    Article  PubMed  Google Scholar 

  5. Berhouma M, Bahri K, Jemel H, Khaldi M (2006) Intracerebral epidermoid tumor: pathogenesis of intraparenchymal location and magnetic resonance imaging findings. J Neuroradiol 33:269–270. https://doi.org/10.1016/S0150-9861(06)77275-3

    Article  CAS  PubMed  Google Scholar 

  6. Salazar J, Vaquero J, Saucedo G, Bravo G (1987) Posterior fossa epidermoid cysts. Acta Neurochir (Wien) 85:34–39. https://doi.org/10.1007/BF01402367

    Article  CAS  Google Scholar 

  7. Yasargil MG, Abernathey CD, Sarioglu AC (1989) Microneurosurgical treatment of intracranial dermoid and epidermoid tumors. Neurosurgery 24:561–567

    Article  CAS  PubMed  Google Scholar 

  8. Magill ST, Lee DS, Yen AJ et al (2018) Surgical outcomes after reoperation for recurrent skull base meningiomas. J Neurosurg 1:1–8. https://doi.org/10.3171/2017.11.JNS172278

    Article  Google Scholar 

  9. Davies JM, Trinh VT, Sneed PK, McDermott MW (2013) Radiotherapy for recurrent epidermoid cyst. J Neurooncol 112:307–313. https://doi.org/10.1007/s11060-013-1065-y

    Article  PubMed  Google Scholar 

  10. Parikh S, Milosevic M, Wong CS, Laperriere N (1995) Recurrent intracranial epidermoid cyst treated with radiotherapy. J Neurooncol 24:293–297

    Article  CAS  PubMed  Google Scholar 

  11. Keville FJ, Wise BL (1959) Intracranial epidermoid and dermoid tumors. J Neurosurg 16:564–569. https://doi.org/10.3171/jns.1959.16.5.0564

    Article  CAS  PubMed  Google Scholar 

  12. Rutherford SA, Leach PA, King AT (2006) Early recurrence of an intracranial epidermoid cyst due to low-grade infection: case report. Skull Base 16:109–116. https://doi.org/10.1055/s-2005-926217

    Article  PubMed  PubMed Central  Google Scholar 

  13. Schiefer TK, Link MJ (2008) Epidermoids of the cerebellopontine angle: a 20-year experience. Surg Neurol 70:584–590. https://doi.org/10.1016/j.surneu.2007.12.021

    Article  PubMed  Google Scholar 

  14. Gopalakrishnan CV, Ansari KA, Nair S, Menon G (2014) Long term outcome in surgically treated posterior fossa epidermoids. Clin Neurol Neurosurg 117:93–99. https://doi.org/10.1016/j.clineuro.2013.11.025

    Article  PubMed  Google Scholar 

  15. Talacchi A, Sala F, Alessandrini F et al (1998) Assessment and surgical management of posterior fossa epidermoid tumors: report of 28 cases. Neurosurgery 42:242–251

    Article  CAS  PubMed  Google Scholar 

  16. Kobata H, Kondo A, Iwasaki K (2002) Cerebellopontine angle epidermoids presenting with cranial nerve hyperactive dysfunction: pathogenesis and long-term surgical results in 30 patients. Neurosurgery 50:276–285

    PubMed  Google Scholar 

  17. Altschuler EM, Jungreis CA, Sekhar LN et al (1990) Operative treatment of intracranial epidermoid cysts and cholesterol granulomas: report of 21 cases. Neurosurgery 26:606–613 (discussion 614)

    Article  CAS  PubMed  Google Scholar 

  18. Alvord ECJ (1977) Growth rates of epidermoid tumors. Ann Neurol 2:367–370. https://doi.org/10.1002/ana.410020504

    Article  PubMed  Google Scholar 

  19. Morishita T, Watanabe T, Ohta T et al (2009) Atypical epidermoid cyst with repetitive hemorrhages in the supracallosal region: case report. Neurol Med Chir (Tokyo) 49:492–494. https://doi.org/10.2176/nmc.49.492

    Article  Google Scholar 

  20. Marks LB, Yorke ED, Jackson A et al (2010) Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys 76:S10–S19. https://doi.org/10.1016/j.ijrobp.2009.07.1754

    Article  PubMed  PubMed Central  Google Scholar 

  21. Yamanaka R, Hayano A, Kanayama T (2017) Radiation-induced meningiomas: an exhaustive review of the literature. World Neurosurg 97:635–644. https://doi.org/10.1016/j.wneu.2016.09.094

    Article  PubMed  Google Scholar 

  22. Hamlat A, Hua Z-F, Saikali S et al (2005) Malignant transformation of intra-cranial epithelial cysts: systematic article review. J Neurooncol 74:187–194. https://doi.org/10.1007/s11060-004-5175-4

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ramin A. Morshed.

Ethics declarations

Conflicts of interest

The authors declare that they have no competing interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Per the institutional Committee on Human Research, informed consent for the retrospective review was not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Morshed, R.A., Wu, S.Y., Sneed, P.K. et al. Radiotherapy for recurrent intracranial epidermoid cysts without malignant transformation: a single-institution case series. J Neurooncol 144, 89–96 (2019). https://doi.org/10.1007/s11060-019-03202-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-019-03202-2

Keywords

Navigation