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Intracranial epidermoid cyst with malignant degeneration and leptomeningeal carcinomatosis: illustrative case

Year: 2025

Type: article

Abstract: BACKGROUND: Malignant transformation of epidermoid cysts (ECs) into squamous cell carcinoma (SCC) is extremely rare, with associated leptomeningeal carcinomatosis being much less likely. Malignant transformation of ECs has a poor prognosis with a median overall survival of 10 months following transformation. OBSERVATIONS: A 59-year-old male with a history of a subtotally resected posterior fossa EC presented with worsening symptoms 14 years following the initial subtotal resection. Imaging showed obstructive hydrocephalus and extensive leptomeningeal carcinomatosis. Laboratory workup confirmed malignant transformation to SCC. LESSONS: Nonmalignant recurrence of benign ECs is relatively common, often due to the complexity of complete resection and adherence to adjacent neurovascular structures. On the other hand, malignant degeneration of an EC is extremely rare. Any rapid change in symptoms, failure to recover following surgery, and new areas of irregular thickening and enhancement on imaging should prompt further evaluation for this process. https://thejns.org/doi/10.3171/CASE24738.

Source: Journal of Neurosurgery Case Lessons

DOI: 10.3171/case24738

Authors: Hussein Alsadi, Kelly Dahlstrom, Kyle Summers, Paul J. Camarata, Kyle Werth

Institution: University of Kansas Medical Center

Language: English

Topic: Teratomas and Epidermoid Cysts

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

OpenAlex ID: W4407095211

FWCI: 3.474

Cites: 14

Cited by: 4

Related to: 10