Intracranial epidermoid tumors. A continuing diagnostic challenge
K. P. Panagopoulos, M. el-Azouzi, H. L. Chisholm, F. A. Jolesz and P. M. Black
Neurosurgical Service, Brigham and Women's Hospital, Boston, Mass.
Epidermoid tumors are benign, slowly growing intracranial masses that still
present difficulty in preoperative diagnosis. This article reviews six
cases of histologically proven epidermoid tumors. Computed tomography and
magnetic resonance imaging were complementary in their evaluation. Computed
tomography demonstrated a hypodense, smoothly contoured extra-axial
paramedian mass with lower density than cerebrospinal fluid. Magnetic
resonance imaging usually demonstrated an irregularly but sharply
marginated mass with inhomogeneous density, variable enhancement with
gadolinium, lack of edema in adjacent normal structures, extensive
insinuation into cisternal and other cerebrospinal fluid spaces, and a
high-signal intensity on proton-weighted images. Multiplanar magnetic
resonance imaging was extremely helpful in displaying the full anatomic
extent of the lesion and its relationship with other structures.
