Ruptured Central Nervous System Dermoid Cyst of Suprasellar Region Manifesting as Unusual Epileptic Seizure

World Neurosurg. 2019 Feb:122:150-154. doi: 10.1016/j.wneu.2018.10.153. Epub 2018 Nov 2.

Abstract

Background: Central nervous system dermoid cysts are rare lesions derived from ectopic epithelial cells. They are slow-growing benign tumors but may cause significant morbidity through compression of neurologic and vascular structures and, rarely, rupture into the subarachnoid space.

Case description: We present a rare case of a spontaneously ruptured intracranial dermoid cyst in a 32-year-old man presenting as new-onset epileptic seizures due to chemical meningitis caused by dissemination of fat or lipid droplets.

Conclusions: The dermoid cyst is a rare entity, the rupture of which is exceptional and often spontaneous. It is manifested by a polymorphic and nonspecific clinical picture requiring the use of imaging. This is based on CT and especially MRI, which make it possible to positively diagnose the nature of the cyst and the rupture, specify the extent of the dissemination of the lipid content in the subarachnoid spaces, and detect possible complications such as hydrocephalus. It also makes it possible to carry out a precise topographic assessment to plan the therapeutic conduct and guide a possible surgical intervention.

Keywords: Dermoid cyst; Fat; Spontaneous rupture.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dermoid Cyst / complications*
  • Dermoid Cyst / diagnosis*
  • Dermoid Cyst / pathology
  • Dermoid Cyst / surgery
  • Diagnosis, Differential
  • Humans
  • Hydrocephalus / diagnosis
  • Hydrocephalus / etiology
  • Hydrocephalus / pathology
  • Hydrocephalus / surgery
  • Male
  • Rupture, Spontaneous
  • Seizures / diagnosis*
  • Seizures / etiology*
  • Seizures / pathology
  • Seizures / surgery