Ruptured pediatric cerebellopontine angle epidermoid cyst: a case report detailing radiographic evolution and clinical course

Zhe Guan University of Michigan Medical School; and

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Todd Hollon Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan

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J. Nicole Bentley Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan

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Hugh J. L. Garton Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan

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Epidermoid cysts (ECs) are uncommon pediatric tumors that often occur in the cerebellopontine angle. Although cyst rupture is a recognized complication, the radiographic evolution of an EC following rupture and the resultant parenchymal brainstem edema have not been reported. The authors present the case of a 13-year-old female with a newly diagnosed cerebellopontine angle EC who presented with worsening headaches, photophobia, and emesis. Magnetic resonance imaging demonstrated significant pericystic brainstem edema and mass effect with effacement of the fourth ventricle. Refractory symptoms prompted repeat imaging, revealing cyst enlargement and dense rim enhancement. Resection of the EC resolved both her symptoms and the brainstem edema. This case documents the radiographic evolution of EC rupture and subsequent clinical course.

ABBREVIATIONS

CN = cranial nerve; CPA = cerebellopontine angle; EC = epidermoid cyst; ED = emergency department.
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