title: Unusual coexistence of an epidermoid cyst with an atypical meningioma: Case report and review of the literature.
abstract: BACKGROUND
  Coexistence of multiple primary intracranial tumors of different cell types has rarely been documented; the association of a meningioma and a glioma has been reported as the most common combination. Hereby, we report an unusual case of a temporal epidermoid cyst coexisting with an atypical meningioma.
  
  
  METHODS
  A 37-year-old male presented with progressive symptoms of raised intracranial progression with progressive loss of vision without any neurological deficit. On admission, magnetic resonance imaging (MRI) revealed a right frontal lesion appearing hypointense T1, hyperintense T2 slightly enhanced after gadolinium and a second right temporal, isointense T1, hyperintense T2 non-enhancing lesion. A right frontotemporal craniotomy was performed that revealed two distinct lesions: The whitish temporal lesion with the pearl appearance reminding of an epidermoid cyst, the second lesion was extraaxial fibrous lesion arising from the falx. Pathology confirmed an atypical meningioma WHO Grade II and an epidermoid cyst.
  
  
  CONCLUSIONS
  The simultaneous occurrence of primary intracranial tumors of different cell types is rare. Epidermoid cysts are slow growing lesions believed to arise from inclusion of ectodermal elements during neural tube closure, while meningiomas arise from arachnoidal cells; their association has rarely been reported previously.
authors.affiliation: Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco.
authors.forename: Claire
authors.initials: C
authors.lastname: Karekezi
authors.affiliation: Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco.
authors.forename: Nizare
authors.initials: N
authors.lastname: El Fatemi
authors.affiliation: Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco.
authors.forename: Komi
authors.initials: K
authors.lastname: Egu
authors.affiliation: Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ibrahimi
authors.affiliation: Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco.
authors.forename: Moulay Rachid
authors.initials: MR
authors.lastname: El Maaqili
authors.affiliation: Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco.
authors.forename: Najia
authors.initials: N
authors.lastname: El Abbadi
keywords: Epidermoid cyst; meningioma; multiple tumors