{"title":"Epidermoid Cyst of the Skull: A Case Highlighting Long-Term Evolution and Advanced Imaging Features","authors":"Zi-Lin Zhao, Cong Huang","doi":"10.1016/j.wneu.2025.123893","DOIUrl":null,"url":null,"abstract":"<div><div>This study presents a congenital cranial epidermoid cyst with an unprecedented 70-year latency period, elucidating its distinct clinicoradiological features. A 72-year-old woman presented with a slowly enlarging, painless mass in the left frontoparietal region. Imaging revealed skull erosion, restricted diffusion on diffusion-weighted imaging, and hypoperfusion on perfusion-weighted imaging. Cinematic rendering was innovatively applied, providing three-dimensional visualization of intracystic cholesterol deposits and calcifications, which guided precise surgical excision (pathologically confirmed keratin debris). Key takeaways include identification of exceptionally prolonged latency (longest documented), advocating lifelong surveillance; demonstration of superiority of cinematic rendering in resolving complex internal architecture (e.g., solid-cystic interfaces, heterogeneous components), revolutionizing preoperative evaluation protocols; and establishment of a multimodal imaging signature (restricted diffusion + hypoperfusion + computed tomography density heterogeneity) strongly correlated with histologic constituents (keratin/calcifications), enhancing diagnostic specificity. This study provides novel evidence for personalized management and advanced imaging assessment of cranial epidermoid cysts.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123893"},"PeriodicalIF":1.9000,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1878875025002499","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
This study presents a congenital cranial epidermoid cyst with an unprecedented 70-year latency period, elucidating its distinct clinicoradiological features. A 72-year-old woman presented with a slowly enlarging, painless mass in the left frontoparietal region. Imaging revealed skull erosion, restricted diffusion on diffusion-weighted imaging, and hypoperfusion on perfusion-weighted imaging. Cinematic rendering was innovatively applied, providing three-dimensional visualization of intracystic cholesterol deposits and calcifications, which guided precise surgical excision (pathologically confirmed keratin debris). Key takeaways include identification of exceptionally prolonged latency (longest documented), advocating lifelong surveillance; demonstration of superiority of cinematic rendering in resolving complex internal architecture (e.g., solid-cystic interfaces, heterogeneous components), revolutionizing preoperative evaluation protocols; and establishment of a multimodal imaging signature (restricted diffusion + hypoperfusion + computed tomography density heterogeneity) strongly correlated with histologic constituents (keratin/calcifications), enhancing diagnostic specificity. This study provides novel evidence for personalized management and advanced imaging assessment of cranial epidermoid cysts.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS