Bilateral lateral ventricular epidermoid cyst: A case report

Introduction

Epidermoid cysts are benign inclusion cysts that arise from ectopically displaced ectodermal tissue. Intraventricular epidermoid cysts are uncommon, and involvement of the bilateral lateral ventricles is rarely reported. Computed tomography (CT) scans typically show well-localized, hypodense lesions. These cysts are slightly hyperintense to cerebrospinal fluid (CSF) on both T1 and T2 magnetic resonance imaging (MRI) sequences.

Case presentation

We report a 17-year-old male diagnosed with bilateral lateral ventricular epidermoid cysts after presenting with a four-year history of episodic generalized tonic-clonic seizures and recurrent throbbing global headache. He had surgery, and histopathology confirmed an epidermoid cyst. Postoperatively, the patient experienced symptom improvement.

Discussion

Intracranial epidermoid cysts are benign, accounting for 0.2 %–1.8 % of intracranial tumors. Lateral ventricular epidermoids present with obstructive hydrocephalus and signs and symptoms of increased intracranial pressure. Pathological analysis reveals a pearly white tumor composed of simple squamous cells with abundant laminated and compacted keratin and positivity for epithelial membrane antigen. Both microscopic and endoscopic techniques can be used for the resection of lateral ventricular epidermoid cysts.

Conclusion

Lateral ventricular epidermoids are rare benign lesions. Clinical features include symptoms of increased intracranial pressure, such as headache, vomiting, and altered mentation. MRI is the diagnostic imaging modality of choice. Complete surgical resection is curative, with rare reports of recurrence after subtotal resection. Follow-up is crucial to monitor for recurrence and other associated complications.