Subarachnoid fat dissemination after resection of a cerebellopontine angle dysontogenic cyst: case report and review of the literature.
OBJECTIVE
This case report illustrates the clinical and radiological relevance of extensive intracranial subarachnoid and ventricular dissemination in dysontogenic (dermoid) tumors.


METHODS
We describe a patient with a cerebellopontine angle dysontogenic tumor. Postoperatively, the cyst disseminated fat particles extensively into the subarachnoid space. Magnetic resonance imaging (MRI) studies revealed continuous dispersion of the fat particles into the cerebral cisterns, subarachnoid space, and ventricles.


METHODS
Eight years of clinical and MRI follow-up demonstrated neither neurological deterioration in the patient nor growth of the multiple lesions.


CONCLUSIONS
Intracranial subarachnoid dissemination of fat material may occur during the preoperative or postoperative course of dermoid and epidermoid cysts. Aseptic meningitis or other complications such as hydrocephalus, seizures, or cranial nerve deficits also may occur owing to spillage of intracranial cyst contents into the subarachnoid space. MRI can detect the presence of fat drops that may adhere to the surrounding structures or migrate with the cerebrospinal fluid flow. Intracranial disseminated fat particles can remain silent without radiological or neurological change, justifying a wait-and-see approach. During long-term postoperative follow-up, however, regular MRI studies and clinical examinations are necessary to avoid potential complications.
Carvalho
G A
GA
Department of Neurosurgery, Hannover Medical School, Germany. gacarvalho@compuserve.com
Cervio
A
A
Matthies
C
C
Samii
M
M
D000328:Adult; D002528:Cerebellar Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002530:Cerebellopontine Angle / Q000473:pathology / Q000601:surgery*; D002552:Cerebral Ventricles / Q000473:pathology; D003884:Dermoid Cyst / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008055:Lipids; D008279:Magnetic Resonance Imaging; D011183:Postoperative Complications / Q000473:pathology*; D013346:Subarachnoid Space / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D008055:Lipids