title: Surgical treatment of an intracranial epidermoid cyst in a dog.
abstract: OBJECTIVE
  To report challenges and complications associated with surgical intracranial epidermoid cyst removal from the fourth ventricle of a dog.
  
  
  METHODS
  Clinical report.
  
  
  METHODS
  Labrador retriever (7 years old) with focal seizures.
  
  
  METHODS
  Magnetic resonance imaging (MRI) revealed an oval lesion in the fourth ventricle. This lesion was heterogeneously hyperintense on T2-weighted and fluid attenuation inversion recovery (FLAIR) images and hypointense on T1-weighted images. Dilatation of the ventricular system was present. A ventriculoperitoneal shunt (VPS) was placed and the fourth ventricle was approached by suboccipital craniectomy. An oval, white mass was identified in the fourth ventricle. Subtotal removal of the mass was performed.
  
  
  RESULTS
  On the day after surgery, neurologic deterioration was observed. The dog had severe cerebellar and brainstem dysfunction. Histopathologic examination of the removed tissue revealed an epidermoid cyst. The dog experienced gradual neurologic improvement; however, neurologic deterioration beginning at 6 months resulted in euthanasia 8 months after surgery. On necropsy, epidermoid cyst tissue was identified in the fourth ventricle.
  
  
  CONCLUSIONS
  Surgical removal of an intracranial epidermoid cyst may be complicated by adhesions between the cyst capsule and surrounding neurovascular structures, causing postoperative morbidity and eventual recurrence of clinical signs. These observations should be taken into account when considering surgical removal of an intracranial epidermoid cyst.
authors: Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, England. sdedecker@rvc.ac.uk
authors: Steven
authors: S
authors: De Decker
authors: Emma
authors: E
authors: Davies
authors: Livia
authors: L
authors: Benigni
authors: Helen
authors: H
authors: Wilson
authors: Ludovic
authors: L
authors: Pelligand
authors: Emma L
authors: EL
authors: Rayner
authors: Nadia
authors: N
authors: Shihab
authors: Holger A
authors: HA
authors: Volk
mesh_terms: D000818:Animals; D001927:Brain Diseases / Q000601:surgery / Q000662:veterinary*; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D004814:Epidermal Cyst / Q000601:surgery / Q000662:veterinary*