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Journal of Neuro-Oncology

, Volume 138, Issue 3, pp 591–599 | Cite as

Intraparenchymal epidermoid cyst: proper surgical management may lead to satisfactory outcome

Clinical Study

Abstract

Intraparenchymal epidermoid cysts (IECs) are rare lesions, thus the preoperative diagnosis and proper surgical management are still a challenge. We searched the database at our institution and performed a search of English literature in PubMed and Google Scholar. Keywords used were as follows: “intraparenchymal”; “intracerebral”; “intraaxial”; “epidermoid cyst”; “brainstem”; “cholesteatoma”; “pearly tumor”. Only cases that were true intraparenchymally located and contained adequate clinical information were included. Six cases of IECs were recorded at our institution. Total removal was achieved in all the six patients with good outcomes. 29 cases meeting the above criteria were found in the literature. Including ours, a total of 35 patients were analyzed. Females were more frequently affected (F/M ratio, 1.9:1). Most of them were located in the brainstem (42.9%) and temporal lobe (22.9%). While in children, all were located in the brainstem. 45.2% showed subtle peripheral enhancement on Magnetic Resonance Imaging (MRI), and all appeared hyperintense on Diffusion Weighted Imaging (DWI). In the subgroup of cerebral lobes and cerebellums, total resection was achieved in 89.5%, and they all showed good outcomes. While in the subgroup of brainstem, 46.7% (seven cases) underwent total resection and 50% (three cases) of them died postoperatively. MRI with DWI is helpful in the preoperative diagnosis. Total resection should be achieved for the IECs located in cerebral lobes and cerebellums, while subtotal resection is a wise and safe strategy for the IECs located in the brainstem.

Keywords

Intraparenchymal epidermoid cyst Magnetic resonance imaging Diffusion weighted imaging Total resection Subtotal resection 

Notes

Acknowledgements

The work was supported by the grant of the National Nature Science Foundation of China (Grant No. 81701153).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina

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