Quistes dermoides y epidermoides intracraneales / Dermoid and epidermoid itracranial cysts

Objective. To present the clinical and radiologic features and surgical results in the management of dermal and epidermal cysts treated in our institution between 1997 and 2006. Material a method. Age, sex, way of presentation, location, radiologic features, surgical technique and compications of 15 epidermal and 1 dermal tumors diagnosed between may 1997 and October 2006, were retrospectively assessed. Results. Mean age: 43 yrs. Most frequent clinical manifestation: headache. Most tumors were at CPA. All resections were done with microsurgical technique. There were 3 cases of chemical meningitis that resolve without sequel. Discussion. Dermal and epidermal cysts are originated by inclusion of ectodermic material at the moment of occlusion of the neural tube. They represent the 0.3-1.5 of intracranial tumors beeng dermal 5-9 times less frequent. The most frequent location of epidermal cysts is at the CPA while dermal are more frequent in the midline. Clinical fatures depend on location. MRI is the gold standard for diagnosis, epecially the DWI sequence. CT is important for the detection of bone invasion. Treatement is so extensive as possible surgical resection, difficult, sometimes because of strong adhesions to eloquent structures. Conclusion. Dermal and epidermal cysts are high fat content lesions, that produce edherence to neural structures. Surgical excision is the election tratement.

Carcinomatous transformation of a sublingual dermoid cyst. A case report.

Sublingual dermoid cysts are rare lesions. Typically they present as slow-growing masses that may cause elevation of the tongue, interference with speech or the appearance of a double chin. We report the first case of malignant transformation to squamous cell carcinoma of a long-standing sublingual dermoid cyst.

[A one-stage combined approach to tumors in the anterobasal portions of the third ventricle]. / Ednoetapen kombiniran dostup do tumorite v predno-bazalnite otdeli na III ventrikul.

Regardless of the current progress in microneurosurgery, the operative management of tumors in the third ventricle is associated with a number of difficulties, and poses a serious challenge to surgeons. A numerous group of neoplasms with the aforementioned location are characterized by developmental course with secondary involvement of the III ventricle. Usually, it is a matter of tumors with suprasellar evolution (craniopharyngiomas, hypophyseal adenomas etc), penetrating through lamina terminalis and growing within the cavity of the ventricle. Radical removal of some of these tumors requires a many-staged approach--basal and transventricular--undertaken at different periods of time. The analysis covers five patients presenting tumors of the III ventricle--4 craniopharyngiomas and 1 dermoid cyst--where single stage basal (across lamina terminalis) and direct (transcallosal or across the lateral ventricle) access to the third ventricle is gained. The situations where such an approach is practicable, the peculiarities of the surgical technique, and the treatment results are discussed.

Post-operative radiotherapy for recurrent dermoid cysts of the spine: a report of 3 cases.

We report three cases of recurrent, intraspinal dermoid cysts managed with post-operative radical radiotherapy. In all cases, the period between last surgery and cystic re-accumulation has been lengthened by the use of involved-field radiotherapy. This combined-modality approach could be beneficial in decreasing the probability of recurrence associated with incompletely-resected tumours, or in patients whose co-morbidities put them at increased operative risk for serial neurosurgical procedures.

[Malignant epidermoid degeneration of dermoid cysts of the ovary. Apropos of 2 cases]. / Dégénérescence maligne épidermoïde des kystes dermoïdes de l'ovaire. A propos de deux observations.

Malignant transformation of benign ovarian cystic teratomas has been reported in 0.5 to 2% of cases. Many different types of cancer can develop, including squamous cell carcinoma, which is by far the most frequent (75%). The mean age of diagnosis is over 50 years. Minimal surgical techniques have been increasingly popular and laparoscopic removal of benign ovarian cysts has become common practice. Malignant transformation is rare but needs to be recognized in order to avoid dissemination of malignant cells during surgery. Direct invasion of the adjacent pelvic structures and small intestine represents the most common mode of spread. Survival is not improved by post-operative radiotherapy or adjuvant chemotherapy in patients with extracapsular disease. We report two cases, one of which presented with spontaneous ovarian abscess and paraneoplastic hypercalcemia.