title: Epidermoid cysts of the cerebellopontine angle: Clinical features and treatment outcomes.
abstract: OBJECTIVE
  To report clinical characteristics, treatment outcomes and risk of recurrence in patients with surgically treated cerebellopontine angle epidermoids.
  
  
  METHODS
  In 1994-2013, we operated 17 patients, including 7 with tumor limited to the cerebellopontine angle, 7 with cerebellopontine angle tumor penetrating supratentorially, and 3 with cerebellopontine angle tumor extending along skull base to contralateral cerebellopontine angle. All patients were followed-up for the mean duration of 126 months.
  
  
  RESULTS
  On admission cranial nerve symptoms predominated. Total tumor removal was achieved in 5 patients, and incomplete removal (with small tumor remnants left on vessels, nerves, or brainstem) in 12 patients. Postoperatively, preoperative deficits worsened in 2 and new postoperative deficits occurred in 10 patients. The extent of tumor expansion had no effect on postoperative morbidity and risk of recurrence. During long-term follow-up, improvement or resolution of preoperative deficits was seen in 11 of 17 patients, and new postoperative deficits in 8 of 10 patients. Symptomatic recurrences after an average of more than 9 years were noted in 5 patients, 3 of whom were reoperated. Recurrences occurred in some younger patients and always in area of primary tumor. No effect of extent of tumor removal on risk of recurrence was found.
  
  
  CONCLUSIONS
  The extent of tumor removal had no effect on the risk of recurrence, and thus it may be acceptable to leave tumor capsule fragments adhering closely to nerves, vessels, or brainstem. During long-term follow-up, resolution or improvement of present preoperatively and new postoperative neurological deficits may be expected in most patients.
authors.affiliation: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland. Electronic address: tczernicki@wp.pl.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Czernicki
authors.affiliation: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Kunert
authors.affiliation: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Nowak
authors.affiliation: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Jakub
authors.initials: J
authors.lastname: Wojciechowski
authors.affiliation: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Marchel
mesh_terms: D000293:Adolescent; D000328:Adult; D002528:Cerebellar Neoplasms / Q000473:pathology* / Q000601:surgery; D002530:Cerebellopontine Angle / Q000473:pathology* / Q000601:surgery; D004814:Epidermal Cyst / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D017063:Outcome Assessment, Health Care; D055815:Young Adult
keywords: Cerebellopontine angle; Cranial nerve deficits; Epidermoid cyst; Surgery; Treatment outcome