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CPA-IAC Epidermoid Cyst
Philip R. Chapman, MD; H. Ric Harnsberger, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Epidermoid tumor, primary cholesteatoma, or epithelial inclusion cyst
            • Definitions

              • Congenital inclusion of ectodermal epithelial elements during neural tube closure

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Vernon V et al: Surgical management of cerebellopontine angle epidermoid cysts: an institutional experience of 10 years. Br J Neurosurg. 1-10, 2021
                                          2. Shear BM et al: Extent of resection of epidermoid tumors and risk of recurrence: case report and meta-analysis. J Neurosurg. 1-11, 2019
                                          3. Andica C et al: Spatial restriction within intracranial epidermoid cysts observed using short diffusion-time diffusion-weighted imaging. Magn Reson Med Sci. 17(3):269-72, 2018
                                          4. Farhoud A et al: Surgical resection of cerebellopontine epidermoid cysts: limitations and outcome. J Neurol Surg B Skull Base. 79(2):167-72, 2018
                                          5. Hasegawa M et al: Cerebellopontine angle epidermoid cysts: clinical presentations and surgical outcome. Neurosurg Rev. 39(2):259-66; discussion 266-7, 2016
                                          6. Gopalakrishnan CV et al: Long term outcome in surgically treated posterior fossa epidermoids. Clin Neurol Neurosurg. 117:93-9, 2014
                                          7. Jolapara M et al: Diffusion tensor mode in imaging of intracranial epidermoid cysts: one step ahead of fractional anisotropy. Neuroradiology. 51(2):123-9, 2009
                                          8. Schiefer TK et al: Epidermoids of the cerebellopontine angle: a 20-year experience. Surg Neurol. 70(6):584-90; discussion 590, 2008
                                          9. Ben Hamouda M et al: Atypical CT and MRI aspects of an epidermoid cyst. J Neuroradiol. 34(2):129-32, 2007
                                          10. Bonneville F et al: Imaging of cerebellopontine angle lesions: an update. Part 2: intra-axial lesions, skull base lesions that may invade the CPA region, and non-enhancing extra-axial lesions. Eur Radiol. 17(11):2908-20, 2007
                                          11. Osborn AG et al: Intracranial cysts: radiologic-pathologic correlation and imaging approach. Radiology. 239(3):650-64, 2006
                                          12. Liu P et al: MR imaging of epidermoids at the cerebellopontine angle. Magn Reson Med Sci. 2(3):109-15, 2003
                                          13. Dutt SN et al: Radiologic differentiation of intracranial epidermoids from arachnoid cysts. Otol Neurotol. 23(1):84-92, 2002
                                          14. Kobata H et al: Cerebellopontine angle epidermoids presenting with cranial nerve hyperactive dysfunction: pathogenesis and long-term surgical results in 30 patients. Neurosurgery. 50(2):276-85; discussion 285-6, 2002
                                          15. Dechambre S et al: Diffusion-weighted MRI postoperative assessment of an epidermoid tumour in the cerebellopontine angle. Neuroradiology. 41(11):829-31, 1999
                                          16. Ochi M et al: Unusual CT and MR appearance of an epidermoid tumor of the cerebellopontine angle. AJNR Am J Neuroradiol. 19(6):1113-5, 1998
                                          17. Talacchi A et al: Assessment and surgical management of posterior fossa epidermoid tumors: report of 28 cases. Neurosurgery. 42(2):242-51; discussion 251-2, 1998
                                          18. Timmer FA et al: Chemical analysis of an epidermoid cyst with unusual CT and MR characteristics. AJNR Am J Neuroradiol. 19(6):1111-2, 1998
                                          19. Ikushima I et al: MR of epidermoids with a variety of pulse sequences. AJNR Am J Neuroradiol. 18(7):1359-63, 1997
                                          20. Kallmes DF et al: Typical and atypical MR imaging features of intracranial epidermoid tumors. AJR Am J Roentgenol. 169(3):883-7, 1997
                                          21. Tien RD et al: Variable bandwidth steady-state free-precession MR imaging: a technique for improving characterization of epidermoid tumor and arachnoid cyst. AJR Am J Roentgenol. 164(3):689-92, 1995
                                          22. Gao PY et al: Radiologic-pathologic correlation. Epidermoid tumor of the cerebellopontine angle. AJNR Am J Neuroradiol. 13(3):863-72, 1992
                                          23. Tsuruda JS et al: Diffusion-weighted MR imaging of the brain: value of differentiating between extraaxial cysts and epidermoid tumors. AJNR Am J Neuroradiol. 11(5):925-31; discussion 932-4, 1990
                                          24. Tampieri D et al: MR imaging of epidermoid cysts. AJNR Am J Neuroradiol. 10(2):351-6, 1989
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Epidermoid tumor, primary cholesteatoma, or epithelial inclusion cyst
                                                    • Definitions

                                                      • Congenital inclusion of ectodermal epithelial elements during neural tube closure

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Vernon V et al: Surgical management of cerebellopontine angle epidermoid cysts: an institutional experience of 10 years. Br J Neurosurg. 1-10, 2021
                                                                                  2. Shear BM et al: Extent of resection of epidermoid tumors and risk of recurrence: case report and meta-analysis. J Neurosurg. 1-11, 2019
                                                                                  3. Andica C et al: Spatial restriction within intracranial epidermoid cysts observed using short diffusion-time diffusion-weighted imaging. Magn Reson Med Sci. 17(3):269-72, 2018
                                                                                  4. Farhoud A et al: Surgical resection of cerebellopontine epidermoid cysts: limitations and outcome. J Neurol Surg B Skull Base. 79(2):167-72, 2018
                                                                                  5. Hasegawa M et al: Cerebellopontine angle epidermoid cysts: clinical presentations and surgical outcome. Neurosurg Rev. 39(2):259-66; discussion 266-7, 2016
                                                                                  6. Gopalakrishnan CV et al: Long term outcome in surgically treated posterior fossa epidermoids. Clin Neurol Neurosurg. 117:93-9, 2014
                                                                                  7. Jolapara M et al: Diffusion tensor mode in imaging of intracranial epidermoid cysts: one step ahead of fractional anisotropy. Neuroradiology. 51(2):123-9, 2009
                                                                                  8. Schiefer TK et al: Epidermoids of the cerebellopontine angle: a 20-year experience. Surg Neurol. 70(6):584-90; discussion 590, 2008
                                                                                  9. Ben Hamouda M et al: Atypical CT and MRI aspects of an epidermoid cyst. J Neuroradiol. 34(2):129-32, 2007
                                                                                  10. Bonneville F et al: Imaging of cerebellopontine angle lesions: an update. Part 2: intra-axial lesions, skull base lesions that may invade the CPA region, and non-enhancing extra-axial lesions. Eur Radiol. 17(11):2908-20, 2007
                                                                                  11. Osborn AG et al: Intracranial cysts: radiologic-pathologic correlation and imaging approach. Radiology. 239(3):650-64, 2006
                                                                                  12. Liu P et al: MR imaging of epidermoids at the cerebellopontine angle. Magn Reson Med Sci. 2(3):109-15, 2003
                                                                                  13. Dutt SN et al: Radiologic differentiation of intracranial epidermoids from arachnoid cysts. Otol Neurotol. 23(1):84-92, 2002
                                                                                  14. Kobata H et al: Cerebellopontine angle epidermoids presenting with cranial nerve hyperactive dysfunction: pathogenesis and long-term surgical results in 30 patients. Neurosurgery. 50(2):276-85; discussion 285-6, 2002
                                                                                  15. Dechambre S et al: Diffusion-weighted MRI postoperative assessment of an epidermoid tumour in the cerebellopontine angle. Neuroradiology. 41(11):829-31, 1999
                                                                                  16. Ochi M et al: Unusual CT and MR appearance of an epidermoid tumor of the cerebellopontine angle. AJNR Am J Neuroradiol. 19(6):1113-5, 1998
                                                                                  17. Talacchi A et al: Assessment and surgical management of posterior fossa epidermoid tumors: report of 28 cases. Neurosurgery. 42(2):242-51; discussion 251-2, 1998
                                                                                  18. Timmer FA et al: Chemical analysis of an epidermoid cyst with unusual CT and MR characteristics. AJNR Am J Neuroradiol. 19(6):1111-2, 1998
                                                                                  19. Ikushima I et al: MR of epidermoids with a variety of pulse sequences. AJNR Am J Neuroradiol. 18(7):1359-63, 1997
                                                                                  20. Kallmes DF et al: Typical and atypical MR imaging features of intracranial epidermoid tumors. AJR Am J Roentgenol. 169(3):883-7, 1997
                                                                                  21. Tien RD et al: Variable bandwidth steady-state free-precession MR imaging: a technique for improving characterization of epidermoid tumor and arachnoid cyst. AJR Am J Roentgenol. 164(3):689-92, 1995
                                                                                  22. Gao PY et al: Radiologic-pathologic correlation. Epidermoid tumor of the cerebellopontine angle. AJNR Am J Neuroradiol. 13(3):863-72, 1992
                                                                                  23. Tsuruda JS et al: Diffusion-weighted MR imaging of the brain: value of differentiating between extraaxial cysts and epidermoid tumors. AJNR Am J Neuroradiol. 11(5):925-31; discussion 932-4, 1990
                                                                                  24. Tampieri D et al: MR imaging of epidermoid cysts. AJNR Am J Neuroradiol. 10(2):351-6, 1989