Our Summary

Epidermoid cysts, abnormal growths that can occur in the brain, are quite rare - making up less than 1% of all brain tumors. This paper discusses a specific type of these cysts, known as giant intradiploic epidermoid cysts, that grow larger than 5 cm and are even more uncommon. The authors describe a case where they successfully removed a 7 cm cyst from the back part of a woman’s skull, who was suffering from severe headaches and dizziness. They stress that it’s important to not only remove the cyst but also its surrounding wall to prevent it from coming back or turning into cancer. This paper also presents the first-ever systematic review of 25 cases of these giant cysts, discussing how they present, their clinical and radiographic features, and how best to treat them.

FAQs

  1. What are epidermoid cysts and how common are they?
  2. What are the symptoms presented by a patient with a giant intradiploic epidermoid cyst?
  3. Why is it crucial to completely resect the cyst wall during the removal of an epidermoid cyst?

Doctor’s Tip

A doctor might tell a patient undergoing tumor resection that complete removal of the tumor, including the cyst wall, is crucial in preventing recurrence and potential malignant transformation. It is important to follow post-operative care instructions and attend regular follow-up appointments to monitor for any signs of recurrence. It is also important to maintain a healthy lifestyle and follow any recommended treatment plans to support overall recovery and well-being.

Suitable For

Patients who are typically recommended tumor resection are those with giant intradiploic epidermoid cysts of the posterior fossa, particularly those exceeding 5 cm in size. These patients may present with symptoms such as chronic headaches and vertigo, as well as signs of neurological deficits. Complete resection of the cyst, including the cyst wall, is crucial in preventing recurrence and malignant transformation. In cases where the cyst is causing significant symptoms or neurological deficits, surgical intervention may be recommended to alleviate these symptoms and prevent further complications.

Timeline

Before tumor resection:

  • Patient experiences symptoms such as chronic headaches and vertigo
  • Imaging studies such as MRI or CT scans are performed to diagnose the tumor
  • Consultation with a neurosurgeon or neurologist to discuss treatment options
  • Pre-operative preparations such as blood tests, physical examination, and anesthesia evaluation

After tumor resection:

  • Surgery is performed to remove the tumor, in this case, a 7 cm posterior fossa epidermoid cyst involving the occipital bone
  • Post-operative recovery in the hospital with monitoring for any complications
  • Follow-up appointments with the neurosurgeon to monitor healing and recovery
  • Rehabilitation or physical therapy if needed to regain strength and function
  • Long-term follow-up to monitor for any signs of recurrence or complications.

What to Ask Your Doctor

  1. What are the potential risks and benefits of tumor resection surgery?

  2. What is the likelihood of the tumor being completely removed during surgery?

  3. What is the expected recovery time after tumor resection surgery?

  4. Are there any alternative treatment options to tumor resection surgery?

  5. What follow-up care or monitoring will be needed after tumor resection surgery?

  6. What are the potential long-term effects or complications of tumor resection surgery?

  7. How will tumor resection surgery affect my quality of life?

  8. Are there any lifestyle changes I should make before or after tumor resection surgery?

  9. What is the experience of the surgical team in performing tumor resection surgeries?

  10. How soon after surgery can I expect to see improvements in my symptoms, such as headaches and vertigo?

Reference

Authors: Nair I, Zammit A, Williamson T, Sadasivan AP. Journal: CNS Oncol. 2024 Dec 31;13(1):2415279. doi: 10.1080/20450907.2024.2415279. Epub 2024 Nov 19. PMID: 39561245