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Dermoid and Epidermoid Cysts
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Ectodermal inclusion cyst, cholesteatoma (ear), epidermal inclusion cyst, dermolipoma (dermoid cyst)
              • Definitions

                • Intracranial inclusions of ectodermal tissue
                • Dermoids contain squamous epithelium & associated dermal appendages
                  • Sebaceous glands, dental enamel, hair follicles
                • Epidermoids consist of squamous epithelium

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Nonvascular Interventions

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Lynch JC et al: Surgical strategy for intracranial dermoid and epidermoid tumors: An experience with 33 Patients. Surg Neurol Int. 5:163, 2014
                                          2. Chowdhury FH et al: Intracranial epidermoid tumor; microneurosurgical management: An experience of 23 cases. Asian J Neurosurg. 8(1):21-8, 2013
                                          3. Ren X et al: Clinical, radiological, and pathological features of 24 atypical intracranial epidermoid cysts. J Neurosurg. 116(3):611-21, 2012
                                          4. Schneider UC et al: Intracranial, supratentorial dermoid cysts in paediatric patients--two cases and a review of the literature. Childs Nerv Syst. 28(2):185-90, 2012
                                          5. Ren XH et al: Delayed postoperative hemorrhage in 21 patients with intracranial epidermoid cysts. J Neurosurg. 114(6):1592-602, 2011
                                          6. 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
                                          7. Liu JK et al: Ruptured intracranial dermoid cysts: clinical, radiographic, and surgical features. Neurosurgery. 62(2):377-84; discussion 384, 2008
                                          8. Orakcioglu B et al: Intracranial dermoid cysts: variations of radiological and clinical features. Acta Neurochir (Wien). 150(12):1227-34; discussion 1234, 2008
                                          9. Caldarelli M et al: Intracranial midline dermoid and epidermoid cysts in children. J Neurosurg. 100(5 Suppl Pediatrics):473-80, 2004
                                          10. Ziv ET et al: Iatrogenic intraspinal epidermoid tumor: two cases and a review of the literature. Spine. 29(1):E15-8, 2004
                                          11. Brown JY et al: Unusual imaging appearance of an intracranial dermoid cyst. AJNR Am J Neuroradiol. 22(10):1970-2, 2001
                                          12. CalabrĂ² F et al: Rupture of spinal dermoid tumors with spread of fatty droplets in the cerebrospinal fluid pathways. Neuroradiology. 42(8):572-9, 2000
                                          13. Higashi S et al: Occipital dermal sinus associated with dermoid cyst in the fourth ventricle. AJNR Am J Neuroradiol. 16(4 Suppl):945-8, 1995
                                          14. Poptani H et al: Characterization of intracranial mass lesions with in vivo proton MR spectroscopy. AJNR Am J Neuroradiol. 16(8):1593-603, 1995
                                          15. Smirniotopoulos JG et al: Teratomas, dermoids, and epidermoids of the head and neck. Radiographics. 15(6):1437-55, 1995
                                          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

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Ectodermal inclusion cyst, cholesteatoma (ear), epidermal inclusion cyst, dermolipoma (dermoid cyst)
                                                      • Definitions

                                                        • Intracranial inclusions of ectodermal tissue
                                                        • Dermoids contain squamous epithelium & associated dermal appendages
                                                          • Sebaceous glands, dental enamel, hair follicles
                                                        • Epidermoids consist of squamous epithelium

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nonvascular Interventions

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Lynch JC et al: Surgical strategy for intracranial dermoid and epidermoid tumors: An experience with 33 Patients. Surg Neurol Int. 5:163, 2014
                                                                                  2. Chowdhury FH et al: Intracranial epidermoid tumor; microneurosurgical management: An experience of 23 cases. Asian J Neurosurg. 8(1):21-8, 2013
                                                                                  3. Ren X et al: Clinical, radiological, and pathological features of 24 atypical intracranial epidermoid cysts. J Neurosurg. 116(3):611-21, 2012
                                                                                  4. Schneider UC et al: Intracranial, supratentorial dermoid cysts in paediatric patients--two cases and a review of the literature. Childs Nerv Syst. 28(2):185-90, 2012
                                                                                  5. Ren XH et al: Delayed postoperative hemorrhage in 21 patients with intracranial epidermoid cysts. J Neurosurg. 114(6):1592-602, 2011
                                                                                  6. 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
                                                                                  7. Liu JK et al: Ruptured intracranial dermoid cysts: clinical, radiographic, and surgical features. Neurosurgery. 62(2):377-84; discussion 384, 2008
                                                                                  8. Orakcioglu B et al: Intracranial dermoid cysts: variations of radiological and clinical features. Acta Neurochir (Wien). 150(12):1227-34; discussion 1234, 2008
                                                                                  9. Caldarelli M et al: Intracranial midline dermoid and epidermoid cysts in children. J Neurosurg. 100(5 Suppl Pediatrics):473-80, 2004
                                                                                  10. Ziv ET et al: Iatrogenic intraspinal epidermoid tumor: two cases and a review of the literature. Spine. 29(1):E15-8, 2004
                                                                                  11. Brown JY et al: Unusual imaging appearance of an intracranial dermoid cyst. AJNR Am J Neuroradiol. 22(10):1970-2, 2001
                                                                                  12. CalabrĂ² F et al: Rupture of spinal dermoid tumors with spread of fatty droplets in the cerebrospinal fluid pathways. Neuroradiology. 42(8):572-9, 2000
                                                                                  13. Higashi S et al: Occipital dermal sinus associated with dermoid cyst in the fourth ventricle. AJNR Am J Neuroradiol. 16(4 Suppl):945-8, 1995
                                                                                  14. Poptani H et al: Characterization of intracranial mass lesions with in vivo proton MR spectroscopy. AJNR Am J Neuroradiol. 16(8):1593-603, 1995
                                                                                  15. Smirniotopoulos JG et al: Teratomas, dermoids, and epidermoids of the head and neck. Radiographics. 15(6):1437-55, 1995