J Korean Ster Func Neurosurg.  2021 Sep;17(2):110-113. 10.52662/jksfn.2021.00060.

Post-traumatic calcified epidermoid cyst in the posterior fossa: a case report

• Park S
• Shin IY

• KMID: 2534581
• DOI: http://doi.org/10.52662/jksfn.2021.00060

Abstract

In rare cases, head trauma can cause epidermal cell invasion into the intracranial space. A 72-year-old man visited our outpatient clinic with abnormal brain magnetic resonance imaging findings. The patient experienced head trauma 20 years ago and complained of progressive cortical impairment 1 year previously. Radiologic findings revealed an 8-cm lobulated tumor in the right occipital convexity with inner calcification and invasion in the dura mater and bone tissue, causing a mass effect. The tumor was assumed to be an atypical meningioma or bone mass. We planned craniectomy, tumor removal, and bone reconstruction. The intraoperative findings included a cystic capsulated tumor with dura mater and skull invasion. After capsule removal, we observed liquified tumor contents with keratin-like material. After surgery, the pathologic report confirmed that the tumor was an epidermoid cyst. On follow-up magnetic resonance imaging, there was no evidence of a remnant tumor. At an outpatient follow-up visit, it was confirmed that the patient had improved performance (modified Rankin scale=2), a mini mental state examination score of 17/30, and physical location awareness. In post-traumatic calcified epidermoid cysts, surgery can be helpful for recovering patients’ neurological deficits by decreasing the mass effect.

Keyword

Epidermoid cyst; Posterior fossa; Trauma; Spatial cognition impairment; Motor coordination