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Epidermoid Cyst
Anne G. Osborn, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Ectodermal inclusion cyst
                • "Pearly" tumor
              • Definitions

                • Intracranial epidermoids are congenital inclusion cysts (not "tumors")
                • Benign, slow-growing congenital lesions derived from ectodermal remnants sequestrated during embryogenesis

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Angiographic 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

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Pons Escoda A et al: Imaging of skull vault tumors in adults. Insights Imaging. 11(1):23, 2020
                                                2. Bobeff EJ et al: Suprasellar Epidermoid Cyst: Case Report of Extended Endoscopic Transsphenoidal Resection and Systematic Review of the Literature. World Neurosurg. 128:514-26, 2019
                                                3. Hitti FL et al: Endoscopic Resection of a Cerebellopontine Angle Epidermoid Cyst via a Retrosigmoid Approach. J Neurol Surg B Skull Base. 80(Suppl 3):S330, 2019
                                                4. Ma J et al: Primary intradiploic epidermoid cyst: a case report with literature review. Clin Neuropathol. 38(1):28-32, 2019
                                                5. Badat N et al: Malignant transformation of epidermoid cyst with diffuse leptomeningeal carcinomatosis on skull base and trigeminal perineural spread. J Neuroradiol. 45(5):337-40, 2018
                                                6. Gollapudi PR et al: A frontal giant intradiploic giant pearl (epidermoid cyst) with intracranial and extracranial extension: a rare entity. J Pediatr Neurosci. 13(4):480-2, 2018
                                                7. Twede JV et al: Intraosseous epidermoid cyst of the skull: case study and radiological imaging considerations. Dermatol Online J. 24(7), 2018
                                                8. Vaz-Guimaraes F et al: Endoscopic endonasal surgery for epidermoid and dermoid cysts: a 10-year experience. J Neurosurg. 1-11, 2018
                                                9. Aboud E et al: Giant intracranial epidermoids: is total removal feasible? J Neurosurg. 1-14, 2015
                                                10. Law EK et al: Atypical intracranial epidermoid cysts: rare anomalies with unique radiological features. Case Rep Radiol. 2015:528632, 2015
                                                11. Demir MK et al: Rare and challenging extra-axial brain lesions: CT and MRI findings with clinico-radiological differential diagnosis and pathological correlation. Diagn Interv Radiol. 20(5):448-52, 2014
                                                12. Vellutini EA et al: Malignant transformation of intracranial epidermoid cyst. Br J Neurosurg. 28(4):507-9, 2014
                                                13. Velamati R et al: Meningitis secondary to ruptured epidermoid cyst: case-based review. Pediatr Ann. 42(6):248-51, 2013
                                                14. Ren X et al: Clinical, radiological, and pathological features of 24 atypical intracranial epidermoid cysts. J Neurosurg. 116(3):611-21, 2012
                                                15. Li F et al: Hyperdense intracranial epidermoid cysts: a study of 15 cases. Acta Neurochir (Wien). 149(1):31-9; discussion 39, 2007
                                                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
                                                              • "Pearly" tumor
                                                            • Definitions

                                                              • Intracranial epidermoids are congenital inclusion cysts (not "tumors")
                                                              • Benign, slow-growing congenital lesions derived from ectodermal remnants sequestrated during embryogenesis

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Angiographic 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

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Pons Escoda A et al: Imaging of skull vault tumors in adults. Insights Imaging. 11(1):23, 2020
                                                                                              2. Bobeff EJ et al: Suprasellar Epidermoid Cyst: Case Report of Extended Endoscopic Transsphenoidal Resection and Systematic Review of the Literature. World Neurosurg. 128:514-26, 2019
                                                                                              3. Hitti FL et al: Endoscopic Resection of a Cerebellopontine Angle Epidermoid Cyst via a Retrosigmoid Approach. J Neurol Surg B Skull Base. 80(Suppl 3):S330, 2019
                                                                                              4. Ma J et al: Primary intradiploic epidermoid cyst: a case report with literature review. Clin Neuropathol. 38(1):28-32, 2019
                                                                                              5. Badat N et al: Malignant transformation of epidermoid cyst with diffuse leptomeningeal carcinomatosis on skull base and trigeminal perineural spread. J Neuroradiol. 45(5):337-40, 2018
                                                                                              6. Gollapudi PR et al: A frontal giant intradiploic giant pearl (epidermoid cyst) with intracranial and extracranial extension: a rare entity. J Pediatr Neurosci. 13(4):480-2, 2018
                                                                                              7. Twede JV et al: Intraosseous epidermoid cyst of the skull: case study and radiological imaging considerations. Dermatol Online J. 24(7), 2018
                                                                                              8. Vaz-Guimaraes F et al: Endoscopic endonasal surgery for epidermoid and dermoid cysts: a 10-year experience. J Neurosurg. 1-11, 2018
                                                                                              9. Aboud E et al: Giant intracranial epidermoids: is total removal feasible? J Neurosurg. 1-14, 2015
                                                                                              10. Law EK et al: Atypical intracranial epidermoid cysts: rare anomalies with unique radiological features. Case Rep Radiol. 2015:528632, 2015
                                                                                              11. Demir MK et al: Rare and challenging extra-axial brain lesions: CT and MRI findings with clinico-radiological differential diagnosis and pathological correlation. Diagn Interv Radiol. 20(5):448-52, 2014
                                                                                              12. Vellutini EA et al: Malignant transformation of intracranial epidermoid cyst. Br J Neurosurg. 28(4):507-9, 2014
                                                                                              13. Velamati R et al: Meningitis secondary to ruptured epidermoid cyst: case-based review. Pediatr Ann. 42(6):248-51, 2013
                                                                                              14. Ren X et al: Clinical, radiological, and pathological features of 24 atypical intracranial epidermoid cysts. J Neurosurg. 116(3):611-21, 2012
                                                                                              15. Li F et al: Hyperdense intracranial epidermoid cysts: a study of 15 cases. Acta Neurochir (Wien). 149(1):31-9; discussion 39, 2007