Presentation
Slow and progressive increase in headaches over a span of two years.
Patient Data
T1: isointense lesion to CSF in the posterior fossa anteriorly more extending to right side
T2: it is confirmed that the lesion follows CSF in most of the sequences
FLAIR: heterogeneous/dirty signal without associated edema
DWI/ADC: increased signal intensity on DWI and ADC with values similar to adjacent brain parenchyma, indicating abnormal restricted diffusion; this pattern is not observed in arachnoid cysts
the lesion exerts mass effect upon the brain stem, mainly compressing the pons and brainstem. It is completely encasing basilar artery and its branches. It also extends to right cerebellopontine angle displacing the right VII and VIII nerves posteriorly. It is also indenting the 4th ventricle
Case Discussion
These tumors are congenital cysts that originate from ectodermal tissue, specifically known as epidermoid cysts. They contain skin cells that have sloughed off. Epidermoids tend to grow slowly and are considered benign when examined under a microscope. Both men and women are equally affected, with the highest incidence occurring between the ages of 20 and 40 1.
The majority of intracranial epidermoids, more than 90%, are found within the layers surrounding the brain and are typically located outside the brain's functional tissue. The cerebellopontine angle cistern is the most common location for these intracranial epidermoids, accounting for almost half of all cases 2.
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