 |
|
|
 |
 |
 |
 |
 For scheduling
please call (972) 566-6444 7777 Forest Lane (map)
|
|
EPIDERMOID & DERMOID CYSTS Both of these tumor types are benign. They are considered to be "developmental", since they result from a failure of migration of ectodermal cells during embryonic development. These cells are then trapped within the growing Brain and are present at birth.These slow growing tumors generally occur in the following locations:
Epidermoid Tumor Epidermoid tumors (often called "Pearly Tumors" because of their appearance at surgery - see Figures 2A-2C) account for 1% of intracranial tumors and approximately 7% of Cerebellar Pontine Angle (Posterior Cranial Fossa and Skull Base) tumors.SYMPTOMS Symptoms usually occur late in the course of the disease process since growth is slow and compression, distortion and stretching of the Brain, Brain Stem and/or Cranial Nerves often is well tolerated until some critical point is reached past which these structures can no longer accommodate. The symptoms (see "Locations" above) will manifest depending on the location of the lesion. Cranial Nerve symptoms are fairly common for those tumors that occur in the Posterior Cranial Fossa and Suprasellar.DIAGNOSIS They are diagnosed by MRI and CT scans. They are often in the same location as Acoustic Neuromas. However, their Neuroimaging characteristics are quite different. Epidermoid Tumors do not enhance with contrast, and often, are indistinct to the point of being unappreciated and undiagnosed. They can be confused with Arachnoid Cysts occurring in the same location. Sophisticated MRI scanning techniques and experienced specialists can usually differentiate between these two entities.
TREATMENT Surgery Surgical resection is the treatment of choice. These tumors have a tendency to have a capsule that is densely attached to surrounding structures including the tiny, delicate vessels of the Brain Stem and Cranial Nerves. This can make complete capsule resection quite difficult, if not impossible, without causing serious injury. In some patients it may be necessary to leave remnants of the capsule behind, which increases the risk of recurrence (See Figures 2A-C).
Radiation Therapy Radiation Therapy is not an option for these tumors, since the tumor is not made up of cells that are dividing (dividing cells - as occurs in Cancer - are the ones that are susceptible to radiation), and will not respond. Radiation therapy does prevent recurrence of Epidermoid Tumors.DERMOID TUMOR Dermoid Tumors represent 0.3% of Brain tumors. Dermoids tend to be located near the midline in contrast to Epidermoid Tumors which are more often laterally placed such as in the Cerebellar Pontine Angle (CPA). Dermoids also tend to be associated with other congenital abnormalities.SYMPTOMS Symptoms are usually dependent on the site of origin of the tumor and consequent to the neural structures that are compromised. One problem that is unique to Dermoid Tumors, although an infrequent occurrence is a condition known as Aseptic (also known as non-infectious) Meningitis. This is unusual as an initial problem that brings the patient to the attention of Neurosurgeons; however, this can occur as a result of rupture of the cyst and spillage of its very irritating contents.DIAGNOSIS The diagnosis is usually made with MRI scanning.
TREATMENT Surgical removal is the only treatment option and is usually curative. Care must be taken not to spill the contents of an Intracranial or Intraspinal Dermoid "cyst" since it can incite in a severe inflammatory response known as Aseptic Meningitis.
|
|
 |
|
All content ©2024 by Neurosurgical Consultants, P.A. Author, Martin L. Lazar, MD, FACS All Rights Reserved. See Usage Notices. |