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Year : 2022  |  Volume : 70  |  Issue : 2  |  Page : 832--833

Epidermoid Cyst of the Cavum Septum Pellucidum: A Case Report and Literature Review

Yu Hu1, Huixin Tan2, Siqing Huang1,  
1 Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
2 Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

Correspondence Address:
Dr. Siqing Huang
No 37, Guo Xue Xiang, Chengdu - 610041, Sichuan Province

How to cite this article:
Hu Y, Tan H, Huang S. Epidermoid Cyst of the Cavum Septum Pellucidum: A Case Report and Literature Review.Neurol India 2022;70:832-833

How to cite this URL:
Hu Y, Tan H, Huang S. Epidermoid Cyst of the Cavum Septum Pellucidum: A Case Report and Literature Review. Neurol India [serial online] 2022 [cited 2022 Aug 11 ];70:832-833
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Full Text

A 29-year-old previously healthy male was admitted with a history of seizures and right lower-extremity weakness for 7 days. On examination, no neurological deficits were detected. Cranial computed tomography (CT) revealed a large, well-defined hypodense intraventricular mass with rim calcification [Figure 1]a. Subsequently, magnetic resonance imaging (MRI) of the brain demonstrated an expansive mass of size 6.8 × 3.6 × 6.2 cm3 located within the cavum septum pellucidum (CSP). The lesion was hypointense on T1-weighted (T1W), hyperintense on T2-weighted (T2W), and heterogeneous intense on fluid-attenuated inversion recovery (FLAIR) images with no contrast enhancement [Figure 1]b,[Figure 1]c,[Figure 1]d,[Figure 1]e,[Figure 1]f.{Figure 1}

The patient underwent microsurgery via a left frontal transcortical approach. Intraoperatively, a well-encapsulated pearly white lesion was seen, indicating a typical epidermoid cyst [Figure 2]a. We attained near-total resection. Histopathologic examination revealed typically thin anucleate squames without any skin appendages, confirming the diagnosis of an epidermoid cyst [Figure 2]b. The patient had an uneventful postoperative course and complete resolution of his symptoms.{Figure 2}

Epidermoid cysts should be considered in the differential diagnosis of lesions within the CSP although very rare.[1] They usually demonstrate somewhat heterogeneous signal intensity on FLAIR and characteristically hyperintense signals with restricted diffusion on diffusion-weighted imaging (DWI) sequences. The displacement of the anterior cerebral arteries and internal cerebral veins is helpful to determine the original site of deeply situated midline epidermoid cysts.[2] Gross total resection is advocated in epidermoid cysts of the CSP, and near-total resection with meticulous lesion monitoring should be performed in cases of tight adhesion.[3],[4]

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2Das KK, Honna RM, Attri G, Khatri D, Gosal JS, Dixit P, et al. A Single-center surgical experience of interhemispheric epidermoids and proposal of a new radiological classification. World Neurosurg 2020;141:e606-14.
3Nagasawa D, Yew A, Safaee M, Fong B, Gopen Q, Parsa AT, et al. Clinical characteristics and diagnostic imaging of epidermoid tumors. J Clin Neurosci 2011;18:1158-62.
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