Neuroendoscopic cystectomy through the posterior approach to the sigmoid sinus for intracranial epidermoid cysts: A review of two cases

Abstract

Background

Intracranial epidermoid cysts are rare benign intracranial tumors originating from ectodermal tissues originating from ectopic embryonic remnants that can occur in any part of the cranium but are most common in the pontine cerebellar angle region. The clinical manifestations of intracranial epidermoid cysts include focal neurological deficits and intracranial hypertension due to the occupying effect, and diagnosis is based mainly on imaging and pathological examination. Intracranial epidermoid cysts are not sensitive to radiotherapy, and surgical resection is currently the only treatment.

Case report

We present the case of two patients with intracranial epidermoid cysts. Patient A was admitted with tinnitus on the right side of the ear, and Patient B was admitted with dizziness and ptosis with decreased vision. Both patients were considered previously healthy highly suspected of having intracranial epidermoid cysts on perfect CT and MRI, and underwent neuroendoscopic cystectomy through the posterior ethmoidal sinus; pathologic examination indicated epidermoid cysts. Postoperative pathologic examination revealed epidermoid cysts. The patient’s symptoms were significantly relieved and there were no signs of recurrence at the postoperative follow-up examination. Unfortunately, both patients had not returned to the hospital for follow-up examinations within 1 year after surgery, resulting in the loss of valuable imaging data. However, telephone follow-up revealed that the patients self-reported no significant discomfort.

Conclusion

The clinical manifestations of intracranial epidermoid cysts are diverse, and imaging and pathologic examinations are important for confirming the diagnosis of this disease. Neuroendoscopic cystectomy through the posterior ethmoid sinus is a safe and effective surgical method.