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Microsurgical resection of an epidermoid cyst of the cerebellopontine angle – A review of three cases

Mirosław Stempniewicz, Paweł Słoniewski, Ewa Iżycka-Świeszewska, Robert Rzepko, Edyta Szurowska

CaseRepClinPractRev 2002; 3(4):264-267

ID: 474490

Background: Epidermoid cysts of the cerebellopontine angle region, although benign in character, may pose a serious problem for neurosurgeons because of their spread, tendency to closely adhere to and involve such structures as the brain stem, cranial nerves and blood vessels.
Case reports: The paper presents three cases of patients who underwent surgical treatment in the Department of Neurosurgery, Medical University of Gdaƒsk in 1998–2000. The patients presented with non-specific symptoms
such as headaches, tinnitus and trigeminal neuralgia. Clinical symptomatology together with CT and MRI results allowed to establish a correct preoperative diagnosis in one patient only. All the three cases of epidermoid cysts were treated surgically, but the decisions concerning the extent and methods of resection were taken individually.
Conclusions: Aggressive surgical treatment in an attempt to remove the tumor radically may lead to neurological deficits such as those observed in the presented cases – slight nerve VII paresis. More conservative methods
of resection, sparing a part of the tumor capsule closely adhering to the vascular structures, nerves or brain stem surface should always be considered. It is important to rinse thoroughly the surgical site with hydrocortisone in Ringer solution in order to remove residual cyst contents.

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