Calcified intracranial epidermoid cyst presented during pregnancy: A case report

We present the case of a 29-year-old female with a history of an intracranial tumor, initially diagnosed at age 22, who presented during her first pregnancy at 23 weeks with a seizure episode. MRI revealed a nonenhancing mass in the middle cranial fossa with high T1-weighted signal intensity. Despite concerns regarding the potential for eclampsia, the patient was conservatively managed with seizure prophylaxis, and a cesarean section was performed at 38 weeks’ gestation. Over the following years, the patient experienced stable imaging findings and mild headaches but later developed worsening symptoms due to mass effect, requiring a Ventriculoperitoneal shunt and subsequent tumor resection. Pathology confirmed the diagnosis of an epidermoid cyst. This case highlights the importance of a multidisciplinary approach to managing intracranial lesions in pregnancy, as early diagnosis and careful coordination between obstetrics, neurology, and neurosurgery teams are crucial to ensuring optimal maternal and fetal outcomes. Additionally, it underscores the need for long-term follow-up in patients with brain lesions during pregnancy, as complications may arise years later, necessitating timely interventions. Notably, this case also demonstrates unique characteristics of an epidermoid cyst with high T1-weighted signal and hyperdensity on CT that remained unchanged over time, favoring the diagnosis of a calcified epidermoid cyst—a rare entity.