title: Epidermoid cyst in Meckel's cave with unusual computed tomography and magnetic resonance imaging findings. Case report.
abstract: A 27-year-old woman presented with headache and occasional numbness over her right face. Computed tomography revealed a hypodense mass in the middle cranial fossa and another adjacent hyperdense mass in the posterior fossa with erosion of the right petrous apex. Magnetic resonance imaging revealed the lesion in the middle cranial fossa as iso- to hypointense on T(1)-weighted and hyperintense on T(2)-weighted imaging, with peripheral enhancement after gadolinium administration, and the adjacent lesion in the posterior fossa as hyperintense on T(1)-weighted and hypointense on T(2)-weighted imaging. During surgery, these lesions mimicking two adjacent distinct tumors were revealed to connect through Meckel's cave. The hypodense lesion in the middle cranial fossa consisted of pearly-like solid contents, and the hyperdense lesion in the posterior cranial fossa consisted of viscid dark-green materials. The tumors were gross totally resected with endoscopic assistance. Histological examination confirmed that the tumor was an epidermoid cyst. The present case cyst indicates that although the diffusion-weighted imaging sequence is useful for detection of intracranial epidermoid cysts, epidermoid cysts including viscous materials with unusual radiological findings could complicate the preoperative diagnosis.
authors.affiliation: Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Arai
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasayama
authors.forename: Junji
authors.initials: J
authors.lastname: Koyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fujita
authors.forename: Kohkichi
authors.initials: K
authors.lastname: Hosoda
authors.forename: Eiji
authors.initials: E
authors.lastname: Kohmura
mesh_terms: D000328:Adult; D035301:Cranial Fossa, Middle / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004388:Dura Mater / Q000000981:diagnostic imaging* / Q000473:pathology; D004814:Epidermal Cyst / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D014276:Trigeminal Nerve