Evolution of epidermoid cyst into dermoid cyst: Embryological explanation and radiological-pathological correlation

Abstract

Intracranial dermoid and epidermoid cysts are usually considered to be two different entities in the radiological and surgical literature. Epidermoid cysts are classically off midline in location, isointense to cerebrospinal fluid on T1 and T2-weighted images and have restricted diffusion, whereas dermoid cysts are classically midline in location, have T1-hyperintense regions due to the presence of fat and show facilitated diffusion. We report a case of radiological epidermoid cyst in baseline imaging, which evolved into a radiological dermoid cyst over time, and explain this unique occurrence with a review of the embryology and histopathogenesis of these cysts.

Keywords

Dermoid cyst epidermoid cyst dermoid cyst rupture diffusion restriction diffusion-weighted imaging (DWI)

Get full access to this article

View all access options for this article.

References

Osborn

Preece

. Intracranial cysts: radiologic-pathologic correlation and imaging approach. Radiology2006; 239: 650–664.

Smirniotopoulos

Chiechi

. Teratomas, dermoids, and epidermoids of the head and neck. Radiographics1995; 15: 1437–1455.

Yikilmaz

Durak

Mavili

et al.

The role of diffusion-weighted magnetic resonance imaging in intracranial cystic lesions. Neuroradiol J2008; 21: 781–790.

Santhosh

Thomas

Radhakrishnan

et al.

Diffusion tensor and tensor metrics imaging in intracranial epidermoid cysts. J Magn Reson Imaging2009; 29: 967–970.

Jolapara

Kesavadas

Radhakrishnan

et al.

Diffusion tensor mode in imaging of intracranial epidermoid cysts: one step ahead of fractional anisotropy. Neuroradiology2009; 51: 123–129.

Smith

. Myth of the mesoderm. Am J Neuroradiol1989; 10: 449.

Karanam

LSP

Rajeswaran

Anupama

et al.

Diagnosis of intracranial epidermoid rupture by MR imaging: a case report. Neuroradiol J2009; 22: 391–395.

Messori

Polonara

Serio

et al.

Expanding experience with spontaneous dermoid rupture in the MRI era: diagnosis and follow-up. Eur J Radiol2002; 43: 19–27.

Orakcioglu

Halatsch

M-E

Fortunati

et al.

Intracranial dermoid cysts: variations of radiological and clinical features. Acta Neurochir (Wien)2008; 150: 1227–1234.

10.

Fanous

Gupta

. Analysis of the growth pattern of a dermoid cyst: case report. J Neurosurg Pediatr2014; 14: 621–625.

11.

Chowdhury

Haque

Sarker

. Intracranial epidermoid tumor; microneurosurgical management: an experience of 23 cases. Asian J Neurosurg2013; 8: 21.

12.

Pizzini

Beltramello

Piovan

et al.

Diffusion-weighted and diffusion tensor magnetic resonance brain imaging: principles and applications. Riv Neuroradiol2003; 16: 207–220.

13.

Kallmes

Provenzale

Cloft

et al.

Typical and atypical MR imaging features of intracranial epidermoid tumors. AJR Am J Roentgenol1997; 169: 883–887.

14.

Pružincová

Wlachovská

Peterský

et al.

MRI appearance of inflamed epidermoid tumors in the suprasellar region. Riv Neuroradiol2003; 16: 873–876.

15.

Law

EKC

Lee

RKL

AWH

et al.

Atypical intracranial epidermoid cysts: rare anomalies with unique radiological features. Case Rep Radiol2015; 2015: 1–4.

16.

Ramdasi

Mahore

Chagla

et al.

White epidermoid at the foramen magnum. Neurol India2014; 62: 577.

17.

Zhu

Liu

et al.

Hyperdense intracranial epidermoid cysts: a study of 15 cases. Acta Neurochir (Wien)2007; 149: 31–39.

18.

Timmer

Sluzewski

Treskes

et al.

Chemical analysis of an epidermoid cyst with unusual CT and MR characteristics. Am J Neuroradiol1998; 19: 1111–1112.

19.

Som

Dillon

Fullerton

et al.

Chronically obstructed sinonasal secretions: observations on T1 and T2 shortening. Radiology1989; 172: 515–520.

20.

Horowitz

Chari

James

et al.

MR of intracranial epidermoid tumors: correlation of in vivo imaging with in vitro 13C spectroscopy. Am J Neuroradiol1990; 11: 299–302.