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2009, Number 4

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Cir Cir 2009; 77 (4)

Quistes epidermoides del ángulo pontocerebeloso. Experiencia en 43 casos con seguimiento a largo plazo

Revuelta-Gutiérrez R, Díaz-Romero PRF, Vales-Hidalgo LO, Hinojosa-González R, Barges-Coll J

Language: Spanish
References: 35
Page: 257-265
PDF size: 214.37 Kb.


ABSTRACT

Background: Epidermoid tumors represent the third most common lesion of the cerebellopontine angle (CPA). Their evolution and clinical features are distinctively characteristic. We present a comprehensive review of the clinical, imaging and surgical aspects of epidermoid cysts of the CPA. Methods: We conducted a case series of patients diagnosed with epidermoid cyst of the CPA who were operated on between 1998 and 2005. The lesions were classified according to their anatomic extent: grade I within the boundaries of the CPA—, grade II with extension to the suprasellar and perimesencephalic cisterns— and grade III with parasellar and temporomesial region involvement. Results: This study was comprised of 43 patients with a mean follow-up of 85 months. Mean age was 34 years, and 67% of the patients were female. The initial symptom was headache in 58.1% of the cases and trigeminal neuralgia in 41.8%. According to our classification, temporomesial involvement (25.6%) was significantly (p = 0.001) associated with a higher incidence of seizures, and trigeminal neuralgia was present in patients with lesions limited to the CPA (p = 0.006). The lesions were reached essentially through a retrosigmoidal approach (39.5%) and surgical excision was deemed to be complete in 65% of the cases. Conclusions: Our grading classification according to the anatomic extension correlates well with clinical presentation, type of surgical approach and extent of surgical removal. It is desirable to reach a consensus on the classification of tumor extension.


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