Giant Epidermoid Cyst: A Rare Cause of Temporal Lobe Epilepsy
Abstract Introduction Epidermoid tumors represent approximately 0.3 to 1.8% of all intracranial brain tumors. Only 1.5% of all intracranial epidermoid cysts (ECs) invade the brain and secondary epilepsy is extremely rare. Since August 2014, a 59-year-old male smoker had been presenting...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2017-07-01
|
| Series: | Journal of Neurological Surgery Reports |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1604281 |
| _version_ | 1818859629995622400 |
|---|---|
| author | Vinicius Gomes Trindade Marcos de Queiroz Teles Gomes Marcelo Prudente do Espirito Santo Manoel Jacobsen Teixeira Wellingson Silva Paiva |
| author_facet | Vinicius Gomes Trindade Marcos de Queiroz Teles Gomes Marcelo Prudente do Espirito Santo Manoel Jacobsen Teixeira Wellingson Silva Paiva |
| author_sort | Vinicius Gomes Trindade |
| collection | DOAJ |
| description | Abstract
Introduction Epidermoid tumors represent approximately 0.3 to 1.8% of all intracranial brain tumors. Only 1.5% of all intracranial epidermoid cysts (ECs) invade the brain and secondary epilepsy is extremely rare. Since August 2014, a 59-year-old male smoker had been presenting bad smell feelings, totaling four episodes with sudden onset and duration of 2 minutes. On September 2014, after a sense of smell episode, it evolved into loss of contact and automatic movements followed by generalized tonic–clonic movements. The brain magnetic resonance imaging revealed an extensive subtemporal lesion affecting anterior, middle, and posterior fossa with invasion of the choroidal fissure and projection to the temporal horn of the lateral ventricle. Pretemporal craniotomy with combined approaches, transsylvian and subtemporal, allowed for the excision of a white keratinized and softened lesion suggestive of EC.
Discussion The optimal surgical strategy in individuals with ECs and seizures is not established. The evaluation of the cause and risk–benefit must be held to choose the appropriate surgical strategy: lesionectomy, lobectomy, or amygdalohippocampectomy. In this case, a lesionectomy was performed due to an absence of evidence of involvement of hippocampus and amygdala.
Conclusion Epilepsy secondary to ECs is a rare association. Lesionectomy can be an option with good results without increasing the morbidity. |
| first_indexed | 2024-12-19T09:15:14Z |
| format | Article |
| id | doaj.art-c5df5e5ac80e4764b89e69c9888da91a |
| institution | Directory Open Access Journal |
| issn | 2193-6358 2193-6366 |
| language | English |
| last_indexed | 2024-12-19T09:15:14Z |
| publishDate | 2017-07-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Journal of Neurological Surgery Reports |
| spelling | doaj.art-c5df5e5ac80e4764b89e69c9888da91a2022-12-21T20:28:07ZengGeorg Thieme Verlag KGJournal of Neurological Surgery Reports2193-63582193-63662017-07-017803e101e10510.1055/s-0037-1604281Giant Epidermoid Cyst: A Rare Cause of Temporal Lobe EpilepsyVinicius Gomes Trindade0Marcos de Queiroz Teles Gomes1Marcelo Prudente do Espirito Santo2Manoel Jacobsen Teixeira3Wellingson Silva Paiva4Division of Neurosurgery, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, BrazilDivision of Neurosurgery, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, BrazilDivision of Neurosurgery, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, BrazilDivision of Neurosurgery, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, BrazilDivision of Neurosurgery, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, BrazilAbstract Introduction Epidermoid tumors represent approximately 0.3 to 1.8% of all intracranial brain tumors. Only 1.5% of all intracranial epidermoid cysts (ECs) invade the brain and secondary epilepsy is extremely rare. Since August 2014, a 59-year-old male smoker had been presenting bad smell feelings, totaling four episodes with sudden onset and duration of 2 minutes. On September 2014, after a sense of smell episode, it evolved into loss of contact and automatic movements followed by generalized tonic–clonic movements. The brain magnetic resonance imaging revealed an extensive subtemporal lesion affecting anterior, middle, and posterior fossa with invasion of the choroidal fissure and projection to the temporal horn of the lateral ventricle. Pretemporal craniotomy with combined approaches, transsylvian and subtemporal, allowed for the excision of a white keratinized and softened lesion suggestive of EC. Discussion The optimal surgical strategy in individuals with ECs and seizures is not established. The evaluation of the cause and risk–benefit must be held to choose the appropriate surgical strategy: lesionectomy, lobectomy, or amygdalohippocampectomy. In this case, a lesionectomy was performed due to an absence of evidence of involvement of hippocampus and amygdala. Conclusion Epilepsy secondary to ECs is a rare association. Lesionectomy can be an option with good results without increasing the morbidity.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1604281epidermoid cystepilepsytemporal lobeseizure |
| spellingShingle | Vinicius Gomes Trindade Marcos de Queiroz Teles Gomes Marcelo Prudente do Espirito Santo Manoel Jacobsen Teixeira Wellingson Silva Paiva Giant Epidermoid Cyst: A Rare Cause of Temporal Lobe Epilepsy Journal of Neurological Surgery Reports epidermoid cyst epilepsy temporal lobe seizure |
| title | Giant Epidermoid Cyst: A Rare Cause of Temporal Lobe Epilepsy |
| title_full | Giant Epidermoid Cyst: A Rare Cause of Temporal Lobe Epilepsy |
| title_fullStr | Giant Epidermoid Cyst: A Rare Cause of Temporal Lobe Epilepsy |
| title_full_unstemmed | Giant Epidermoid Cyst: A Rare Cause of Temporal Lobe Epilepsy |
| title_short | Giant Epidermoid Cyst: A Rare Cause of Temporal Lobe Epilepsy |
| title_sort | giant epidermoid cyst a rare cause of temporal lobe epilepsy |
| topic | epidermoid cyst epilepsy temporal lobe seizure |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1604281 |
| work_keys_str_mv | AT viniciusgomestrindade giantepidermoidcystararecauseoftemporallobeepilepsy AT marcosdequeiroztelesgomes giantepidermoidcystararecauseoftemporallobeepilepsy AT marceloprudentedoespiritosanto giantepidermoidcystararecauseoftemporallobeepilepsy AT manoeljacobsenteixeira giantepidermoidcystararecauseoftemporallobeepilepsy AT wellingsonsilvapaiva giantepidermoidcystararecauseoftemporallobeepilepsy |