Giant intradiploic epidermoid cysts of the skull

Report of two cases

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✓ The authors describe two cases of giant intradiploic epidermoid cysts of the cranial vault in which there was massive intracranial extension causing signs of neurological involvement. The very slow growth and the benign histological nature of these tumors explain their long preoperative evolution and the mild neurological signs in some cases. Roentgenographic and computerized tomography findings permit a correct diagnosis. Complete removal of these cysts and their capsules can be easily accomplished, despite their large size. Total removal of these cysts is associated with a very good long-term prognosis.

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Address reprint requests to: Jean Paul Constans, M.D., Service de Neurochirurgie, Hôpital Sainte-Anne, 1 Rue Cabanis, 75674 Paris Cedex 14, France.

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Figures

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    Case 1. Upper: X-ray film of the skull showing a large lytic lesion in the right frontoparietal bone, delimited by sclerotic borders and containing irregular calcifications. Lower: Computerized tomography scans demonstrating a well circumscribed extracerebral hypodense area surrounded by a hyperdense rim and containing calcified regions.

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    Photomicrograph of a specimen from the epidermoid cyst in Case 1 showing desquamated layers of keratin (a), an external malpighian layer (b), and a collagenous core (c). H & E, × 382.

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    Case 2. Upper: Plain x-ray film of the skull showing a large intradiploic cystic lesion in the left temporoparietal region. Lower: Computerized tomography scans showing massive intracranial extension of the tumor in the right temporal area. Calcifications and erosion of both tables of the vault can be seen.

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