Journal of the Formosan Medical Association
Volume 109, Issue 5 , Pages 390-396, May 2010

Natural Malignant Transformation of an Intracranial Epidermoid Cyst

  • Shuyu Hao

      Affiliations

    • Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
    • Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
    • ,
  • Jie Tang

      Affiliations

    • Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
    • Corresponding Author InformationCorrespondence to: Dr Jie Tang, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan Xili 6, Chongwen District, Beijing 100050, China
    • ,
  • Zhen Wu

      Affiliations

    • Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
    • ,
  • Liwei Zhang

      Affiliations

    • Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
    • ,
  • Junting Zhang

      Affiliations

    • Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
    • ,
  • Zhongcheng Wang

      Affiliations

    • Beijing Neurosurgical Institute, Capital Medical University, Beijing, China

Received 31 October 2008; received in revised form 6 March 2009; accepted 17 July 2009.

Malignant transformation of intracranial epidermoid cyst (EC) is very rare, and when it does occur, the clinical course is aggressive. We present an unusual case of natural malignant transformation of an intracranial EC, without a history of surgery. A 61-year-old woman was diagnosed with an EC in the right cerebellopontine angle and prepontine cistern 6 years before the operation described in this report. Her neurological symptoms deteriorated in the 2 months prior to the present admission. Magnetic resonance imaging revealed an irregular, nodular enhanced lesion in the cerebellopontine angle, prepontine cistern, and temporoparietal lobe. Subtotal resection of the lesion was performed. Pathological examination revealed malignant transformation of the EC. The patient died on postoperative day 36 from brainstem infarction, chemical meningitis, and hydrocephalus. Spontaneous rupture of the EC could have contributed to the malignant transformation. This could have been avoided by early removal of the EC.

Key Words:  epidermoid cyst , intracranial neoplasms , malignant transformation

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PII: S0929-6646(10)60068-X

doi:10.1016/S0929-6646(10)60068-X

Journal of the Formosan Medical Association
Volume 109, Issue 5 , Pages 390-396, May 2010

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