Abstract
Intracranial epidermoid cysts are rare benign congenital lesions for which the mainstay of treatment has been surgical resection. Due to a propensity to grow along the skull base, subtotal resection is often elected to avoid excessive surgical morbidity, but it comes with an increased risk of recurrence with its associated treatment difficulties. We here present the cases of three patients with recurrent epidermoid cyst who underwent multiple surgical resections followed by external beam radiation therapy with excellent results to date.
Similar content being viewed by others
References
Guidetti B, Gagliardi FM (1977) Epidermoid and dermoid cysts. Clinical evaluation and late surgical results. J Neurosurg 47:12–18. doi:10.3171/jns.1977.47.1.0012
Russel D, Rubinstein L (1971) Pathology of tumours of the nervous system. ed 3, London: Edward Arnold Ltd., p 429
Salazar J, Vaquero J, Saucedo G, Bravo G (1987) Posterior fossa epidermoid cysts. Acta Neurochir 85:34–39
Conley F (1985) In: Wilkins R, Rengachary S (eds) Neurosurgery. McGraw-Hill Book Co., New York, pp 668–673
Aribandi M, Wilson NJ (2008) CT and MR imaging features of intracerebral epidermoid—a rare lesion. Br J Radiol 81:e97–e99. doi:10.1259/bjr/42146967
Bergui M, Zhong J, Bradac GB, Sales S (2001) Diffusion-weighted images of intracranial cyst-like lesions. Neuroradiology 43:824–829
Lai P-H, Hsu S-S, Ding S-W, Ko C-W, Fu J-H, Weng M-J et al (2007) Proton magnetic resonance spectroscopy and diffusion-weighted imaging in intracranial cystic mass lesions. Surg Neurol 68(Suppl 1):S25–S36. doi:10.1016/j.surneu.2007.07.080
Hu X-Y, Hu C-H, Fang X-M, Cui L, Zhang Q-H (2008) Intraparenchymal epidermoid cysts in the brain: diagnostic value of MR diffusion-weighted imaging. Clin Radiol 63:813–818. doi:10.1016/j.crad.2008.01.008
Berger MS, Wilson CB (1985) Epidermoid cysts of the posterior fossa. J Neurosurg 62:214–219. doi:10.3171/jns.1985.62.2.0214
Altschuler EM, Jungreis CA, Sekhar LN, Jannetta PJ, Sheptak PE (1990) Operative treatment of intracranial epidermoid cysts and cholesterol granulomas: report of 21 cases. Neurosurgery 26:606–613 discussion 614
Yaşargil MG, Abernathey CD, Sarioglu AC (1989) Microneurosurgical treatment of intracranial dermoid and epidermoid tumors. Neurosurgery 24:561–567
Keville FJ, Wise BL (1959) Intracranial epidermoid and dermoid tumors. J Neurosurg 16:564–569. doi:10.3171/jns.1959.16.5.0564
Parikh S, Milosevic M, Wong CS, Laperriere N (1995) Recurrent intracranial epidermoid cyst treated with radiotherapy. J Neurooncol 24:293–297
Rutherford SA, Leach PA, King AT (2006) Early recurrence of an intracranial epidermoid cyst due to low-grade infection: case report. Skull Base 16(2):109–116. doi:10.1055/s-2005-926217
Ahmed I, Auguste KI, Vachhrajani S, Dirks PB, Drake JM, Rutka JT (2009) Neurosurgical management of intracranial epidermoid tumors in children. Clinical article. J Neurosurg Pediatr 4:91–96. doi:10.3171/2009.4.PEDS08489
Schiefer TK, Link MJ (2008) Epidermoids of the cerebellopontine angle: a 20-year experience. Surg Neurol 70:584–590. doi:10.1016/j.surneu.2007.12.021 discussion 590
Alvord EC (1977) Growth rates of epidermoid tumors. Ann Neurol 2:367–370. doi:10.1002/ana.410020504
Rothberg S, Crounse RG, Lee JL (1961) Glycine-C-14-incorporation into the proteins of normal stratum corneum and the abnormal straum corneum of psoriasis. J Invest Dermatol 37:497–505
Abramson RC, Morawetz RB, Schlitt M (1989) Multiple complications from an intracranial epidermoid cyst: case report and literature review. Neurosurgery 24:574–578
Haig PV (1956) Primary epidermoids of the skull including a case with malignant change. Am J Roentgenol Radium Ther Nucl Med 76:1076–1080
Fox H, South EA (1965) Squamous cell carcinoma developing in an intracranial epidermoid cyst (cholesteatoma). J Neurol Neurosurg Psychiatry 28:276–281
Netsky MG (1988) Epidermoid tumors. Review of the literature. Surg Neurol 29:477–483
Wong SW, Ducker TB, Powers JM (1976) Fulminating parapontine epidermoid carcinoma in a four-year-old boy. Cancer 37:1525–1531
Lewis AJ, Cooper PW, Kassel EE, Schwartz ML (1983) Squamous cell carcinoma arising in a suprasellar epidermoid cyst. Case report. J Neurosurg 59:538–541. doi:10.3171/jns.1983.59.3.0538
Marks LB, Yorke ED, Jackson A, Ten Haken RK, Constine LS, Eisbruch A et al (2010) Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys 76:S10–S19. doi:10.1016/j.ijrobp.2009.07.1754
Litré CF, Colin P, Noudel R, Peruzzi P, Bazin A, Sherpereel B et al (2009) Fractionated stereotactic radiotherapy treatment of cavernous sinus meningiomas: a study of 100 cases. Int J Radiat Oncol Biol Phys 74:1012–1017. doi:10.1016/j.ijrobp.2008.09.012
Milker-Zabel S, Zabel A, Schulz-Ertner D, Schlegel W, Wannenmacher M, Debus J (2005) Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: long-term experience and prognostic factors. Int J Radiat Oncol Biol Phys 61:809–816. doi:10.1016/j.ijrobp.2004.07.669
Kalapurakal J (2005) Radiation therapy in the management of pediatric craniopharyngiomas—a review. Childs Nerv Syst 21:808–816. doi:10.1007/s00381-005-1188-3 ChNS: official journal of the International Society for Pediatric Neurosurgery
Tsang RW, Laperriere NJ, Simpson WJ, Brierley J, Panzarella T, Smyth HS (1993) Glioma arising after radiation therapy for pituitary adenoma. A report of four patients and estimation of risk. Cancer 72:2227–2233
Brada M, Ford D, Ashley S, Bliss JM, Crowley S, Mason M et al (1992) Risk of second brain tumour after conservative surgery and radiotherapy for pituitary adenoma. BMJ (Clinical research ed.) 304:1343–1346
Acknowledgments
The authors report no conflict of interest concerning the subject matter or finding specified in this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Davies, J.M., Trinh, V.T., Sneed, P.K. et al. Radiotherapy for recurrent epidermoid cyst. J Neurooncol 112, 307–313 (2013). https://doi.org/10.1007/s11060-013-1065-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11060-013-1065-y