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.

Article Outline

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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References 

  1. Tamura K , Aoyagi M , Wakimoto H , et al.   Malignant transformation eight years after removal of a benign epidermoid cyst: a case report . J Neurooncol . 2006;79:67–72
  2. Akar Z , Tanriover N , Tuzgen S , et al.   Surgical treatment of intracranial epidermoid tumors . Neurol Med Chir (Tokyo) . 2003;43:275–281
  3. Link MJ , Cohen PL , Breneman JC , et al.   Malignant squamous degeneration of a cerebellopontine angle epidermoid tumor. Case report . J Neurosurg . 2002;97:1237–1243
  4. Sawan B , Vital A , Loiseau H , et al.   Squamous cell carcinoma developing in an intracranial prepontine epidermoid cyst . Ann Pathol . 2000;20:258–260
  5. Hamlat A , Hua ZF , Saikali S , et al.   Malignant transformation of intracranial epithelial cysts: systematic article review . J Neurooncol . 2005;74:187–194
  6. Davidson SI , Small JM . Malignant change in an intracranial epidermoid . J Neurol Neurosurg Psychiatry . 1960;23:176–178
  7. Landers JW , Danielski JJ . Malignant intracranial epidermoid cyst. Report of a case with leptomeningeal spread . Arch Pathol . 1960;70:419–423
  8. Fox H , South EA . Squamous cell carcinoma developing in an intracranial epidermoid cyst (cholesteatoma) . J Neurol Neurosurg Psychiatry . 1965;28:276–281
  9. Dubois PJ , Sage M , Luther JS , et al.   Case report. Malignant change in an intracranial epidermoid cyst . J Comput Assist Tomogr . 1981;5:433–435
  10. Lewis AJ , Cooper PW , Kassel EE , et al.   Squamous cell carcinoma arising in a suprasellar epidermoid cyst. Case report . J Neurosurg . 1983;59:538–541
  11. Goldman SA , Gandy SE . Squamous cell carcinoma as a late complication of intracerebroventricular epidermoid cyst. Case report . J Neurosurg . 1987;66:618–620
  12. Nishiura I , Koyama T , Handa J , et al.   Primary intracranial epidermoid carcinoma-case report . Neurol Med Chir (Tokyo) . 1989;29:600–605
  13. Tognetti F , Lanzino G , Manetto V , et al.   Intracranial squa-mous cell carcinoma arising in remnant of extirpated epidermoid cyst . Br J Neurosurg . 1991;5:303–305
  14. Nishio S , Takeshita I , Morioka T , et al.   Primary intracranial squamous cell carcinomas: report of two cases . Neurosurgery . 1995;37:329–332
  15. Murase S , Yamakawa H , Ohkuma A , et al.   Primary intracranial squamous cell carcinoma-case report . Neurol Med Chir (Tokyo) . 1999;39:49–54
  16. Asahi T , Kurimoto M , Endo S , et al.   Malignant transformation of cerebello-pontine angle epidermoid . J Clin Neurosci . 2001;8:572–574
  17. Guan LM , Qi XX , Zhang JR , et al.   Intracranial squamous cell carcinoma developing in remnant of an epidermoid cyst: case report and literature review . Chin Med J (Engl) . 2004;117:1880–1883
  18. Michael LM , Moss T , Madhu T , et al.   Malignant transformation of posterior fossa epidermoid cyst . Br J Neurosurg . 2005;19:505–510
  19. Pagni F , Brenna A , Leone BE , et al.   Malignant epidermoid cyst of the pineal region with lumbar metastasis . Neuropathology . 2007;27:566–569
  20. Kodama H , Maeda M , Hirokawa Y , et al.   MRI findings of malignant transformation of epidermoid cyst: case report . J Neurooncol . 2007;82:171–174
  21. Agarwal S , Rishi A , Suri V , et al.   Primary intracranial squa-mous cell carcinoma arising in an epidermoid cyst-a case report and review of literature . Clin Neurol Neurosurg . 2007;109:888–891
  22. Kim MS , Kim OL . Primary intracranial squamous cell carcinoma in the brain stem with a cerebellopontine angle epidermoid cyst . J Korean Neurosurg Soc . 2008;44:401–404
  23. Alvord EC . Growth rates of epidermoid tumors . Ann Neurol . 1977;2:367–370

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