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Instituto Nacional de Neurología y Neurocirugía

2009, Number 2

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Arch Neurocien 2009; 14 (2)

Epidermoid tumors of cerebellopontine angle

Díaz-Romero PRF, Balhen MCM, Revuelta GR, Vales HLO, Hinojosa GR, Barges CJ

Language: Spanish
References: 35
Page: 85-93
PDF size: 286.97 Kb.


ABSTRACT

Epidermoid tumors represent the third commonest lesion of the cerebellopontine angle (CPA). Their evolutive and clinical features are distinctively characteristic. This series is a comprehensive review of the clinical, imaging and surgical aspects of the epidermoid cysts of the CPA. Material and methods: a case series and a analysis of other series of patients diagnosed with an epidermoid cyst of the CPA. The lesions were classified according to their anatomical extent; grade I within the boundaries of the CPA, grade II with extension to the suprasellar and perimesencephalic cisterns and grade III with parasellar and temporomesial region involvement. Results: this study involved forty-three patients with a mean age of 34 years old, 67% of them being female. The opening symptom was headache in 58.1% of the cases and trigeminal neuralgia in 41.8%. According to our classification; the temporomesial involvement (25.6%) was significantly (p = 0.001) associated with a higher incidence of seizures and trigeminal neuralgia was present in patients with lesions limited to the CPA (p = 0.006). The lesions were reached essentially through a retrosigmoidal approach (39.5%) and the surgical excision was deemed to be complete in 65% of the cases. Conclusion: these lesions are usually infiltrative at the time of diagnosis and a trigeminal neuralgia as the opening symptom is associated to more limited lesions and a better outcome. Our classification in grades according to the anatomical extension correlates well with clinical presentation, the type of surgical approach and the extent of surgical removal.


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