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References
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Comment
The paper entitled “Intra- and extra-ventricular and supra- and infra-tentorial epidermoid with multiple brain stones” presents some interesting peculiarities, although they are not entirely new as the authors claim. In fact, wrapped in a very long clinical follow-up, it reports, the successful surgical treatment of a tricky space-occupying lesion with transtentorial extension, as well as an intraventricular and cisternal expression. Depending on the perspective, like the theory of the half-full versus the half-empty glass, it is impossible to be 100% sure about the intraventricular origin of the tumor instead of a more common cisternal origin, even in this case. In reality, epidermoids may spread through ambient cistern or choroids fissure in both ways, as we could appreciate in the follow-up of non-operated cases. The real asset of this paper is the extremely rare intra-tumoral formation of multiple calcifications of a stone size. Accordingly, in the presence of intratumoral calcifications, the diagnosis of an epidermoid tumor should be brought in mind. The radiological noise introduced by the presence of calcifications mitigated the pre-operative diagnosis of an epidermoid tumor, as the CT and MRI imaging were not very typical, and this represents a very good teaching point.
Oscar Alves,
Porto, Portugal
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Zhen, HN., Liu, WP., Zhang, X. et al. Intra- and extra-ventricular and supra- and infra-tentorial epidermoid with multiple brain stones. Acta Neurochir 152, 725–726 (2010). https://doi.org/10.1007/s00701-009-0485-0
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DOI: https://doi.org/10.1007/s00701-009-0485-0