LETTER TO THE EDITOR
Year : 2012  |  Volume : 7  |  Issue : 1  |  Page : 79

Posterior fossa dermoid cyst

Eustathios Vlachakis¹, George A Alexiou¹, Kalliopi Stefanaki², George Sfakianos¹, Neofytos Prodromou^1
1 Department of Neurosurgery, Children's Hospital "Agia Sofia,'' Athens, Greece
² Department of Pathology, Children's Hospital "Agia Sofia,'' Athens, Greece

Date of Web Publication

28-Jun-2012

Correspondence Address:
George A Alexiou
Aetideon 52 Holargos, Attikis 11561
Greece

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/1817-1745.97638

How to cite this article: Vlachakis E, Alexiou GA, Stefanaki K, Sfakianos G, Prodromou N. Posterior fossa dermoid cyst. J Pediatr Neurosci 2012;7:79

How to cite this URL: Vlachakis E, Alexiou GA, Stefanaki K, Sfakianos G, Prodromou N. Posterior fossa dermoid cyst. J Pediatr Neurosci [serial online] 2012 [cited 2023 Mar 30];7:79. Available from: https://www.pediatricneurosciences.com/text.asp?2012/7/1/79/97638

Dear Sir,

A 2-year-old boy presented with opisthotonos and gait imbalance. The patient reported several episodes of vomiting over the last month. A sinus tract near the external occipital protuberance was also noted. Fundus examination showed bilateral papilledema. CT that ensued revealed a posterior fossa cystic lesion causing obstructive hydrocephalus [Figure 1]. An emergency external ventricular drain (EVD) was placed. Subsequent Magnetic resonance imaging (MRI) revealed a 50 × 35 × 35 mm cystic lesion behind the 4 ^th ventricle with a 10 mm solid component. Given the presence of the sinus tract, dermoid cyst was the most likely diagnosis [Figure 1]. The patient was operated upon. A dermal sinus tract was identified that extended intracranially. The cyst wall was carefully mobilized and excised completely. Histological examination verified the presence of a dermoid cyst. Postoperative the patient was neurologically intact and the EVD was removed on postoperative day 8. On follow-up MRI carried out 4 months later, no cyst recurrence was noted.

Figure 1: (a) Computed tomography (CT) demonstrating a cystic lesion, compressing the 4th ventricle and causing obstructive hydrocephalus (b) (c– e) Magnetic resonance imaging (MRI) showing a cystic lesion with a 10-mm solid component. (f) Postoperative CT Click here to view

Intracranial dermoid cysts are congenital benign neoplasms that account for 0.1-0.7% of all intracranial tumors. ^[1],[2] Most intracranial cysts arise in the posterior fossa and they usually lead to neurological symptoms such as dizziness, headache, and meningitis during childhood. Patients with a posterior fossa dermoid cyst and an associated dermal sinus may develop bacterial meningitis or abscess formation of the dermoid itself. ^[1] Treatment of the posterior fossa dermoid cyst needs microsurgical excision. Total removal of the dermal sinus and the tumor is preferred in order to minimize the risk of recurrence or malignant transformation. ^[1]

 

References

1.	Alexiou GA, Sfakianos G, Prodromou N. Intracranial dermoid cysts in children. Arch Argent Pediatr 2010;108:191-2.   [PUBMED]
2.	Layadi F, Louhab N, Lmejjati M, Aniba K, Aït Elqadi A, Aït Benali S. Cerebellar dermoid cyst with occipital dermal sinus. Report of two pediatric cases. Pediatr Neurosurg 2006;42:387-90.

Figures

  [Figure 1]