Epidermoid cysts of the cerebellopontine angle in pediatric population-an institutional surgical case series and review of literature.
Source: PubMed, NCBI / U.S. National Library of Medicine
Epidermoid cysts (EC) are rare intracranial lesions, particularly uncommon in children, arising from ectodermal inclusions during neural tube closure. Although they are often located in the cerebellopontine angle (CPA), data on complication and recurrence rates after surgery for EC in this location in children remain limited. We retrospectively reviewed data from children (≤ 18 years) surgically treated for EC in CPA at the Oslo University Hospital-Rikshospitalet between 2004 and 2024, with > 1 year of follow-up. Clinical presentation, imaging, and surgical outcomes were assessed. A systematic review of the literature was conducted according to PRISMA guidelines. Six patients (mean age 15 ± 2 years, range 12-17; male/female ratio 1:2) were included. The most common presenting symptoms were headache (83%) and ataxia (33%). Mean diameter on preoperative MRI was 37 ± 5.4 mm (range 30-45). All patients were treated using the standard retrosigmoid approach. Gross total resection (GTR) was achieved in four patients (67%). Postoperative complications were limited to transient diplopia and hearing impairment, respectively, in two patients (34%). No mortality or permanent morbidity was observed. Recurrence was observed in two patients, in one of them after GTR. EC of the CPA in children can be safely and effectively removed, yielding favorable outcomes with low morbidity. Although GTR should be attem
Abstract
Epidermoid cysts (EC) are rare intracranial lesions, particularly uncommon in children, arising from ectodermal inclusions during neural tube closure. Although they are often located in the cerebellopontine angle (CPA), data on complication and recurrence rates after surgery for EC in this location in children remain limited. We retrospectively reviewed data from children (≤ 18 years) surgically treated for EC in CPA at the Oslo University Hospital-Rikshospitalet between 2004 and 2024, with > 1 year of follow-up. Clinical presentation, imaging, and surgical outcomes were assessed. A systematic review of the literature was conducted according to PRISMA guidelines. Six patients (mean age 15 ± 2 years, range 12-17; male/female ratio 1:2) were included. The most common presenting symptoms were headache (83%) and ataxia (33%). Mean diameter on preoperative MRI was 37 ± 5.4 mm (range 30-45). All patients were treated using the standard retrosigmoid approach. Gross total resection (GTR) was achieved in four patients (67%). Postoperative complications were limited to transient diplopia and hearing impairment, respectively, in two patients (34%). No mortality or permanent morbidity was observed. Recurrence was observed in two patients, in one of them after GTR. EC of the CPA in children can be safely and effectively removed, yielding favorable outcomes with low morbidity. Although GTR should be attempted, residual tissue may persist in hidden anatomical recesses and predispose to recurrence after subtotal removal. Endoscopic assistance may enhance the completeness of resection. Small asymptomatic remnants can be monitored. Long-term MRI follow-up is recommended.