Microsurgical Resection of Craniocervical Dermoid Cyst by Far Lateral Approach: Case Report and Literature Review

• Published in: Arquivos brasileiros de neurocirurgia Vol. 37; no. 4; pp. 339 - 342
• Main Authors: Meguins, Lucas Crociati, Spotti, Antonio Ronaldo, Morais, Dionei Freitas de, Rocha, Carlos Eduardo Dall'Aglio, Caramanti, Ricardo Lourenço, Góes, Mario José
• Format: Journal Article
• Language: English
• Published: Rio de Janeiro, Brazil Thieme Revinter Publicações Ltda 01-12-2018
• Subjects: Case Report | Relato de Caso; dermoid cyst; far lateral approach; cisto dermoide; abordagem extremo-lateral; dermoid cyst; far lateral approach
• ISSN: 0103-5355; 2359-5922
• DOI: 10.1055/s-0038-1676530

Abstract
Introduction
 Intracranial dermoid tumors represent a rare clinical entity that accounts for 0.04 to 0.6% of all intracranial tumors. Their location in the posterior fossa is uncommon.
Objectives
 To report the case of a young woman with a posterior fossa dermoid cyst treated by right far lateral approach.
Case Report
 A 17-year-old woman presenting with swallowing difficulties for 6 weeks was referred for a neurological investigation. A magnetic resonance imaging (MRI) scan showed a hyperintense T1-weighted large expansive lesion occupying the posterior fossa and compressing the anterior face of the brain stem and cerebellum. The patient underwent surgical treatment by right far lateral approach with decompression of vascular and neural structures. The patient presented an uneventful recovery, and was discharged home on the fourth postoperative day without any additional neurological deficits. The anatomopathological analysis confirmed the diagnosis of dermoid cyst.
Conclusion
 The far lateral approach is a safe and feasible route to appropriately treat large posterior fossa dermoid cysts. Decompression of vascular and neural structures is essential to achieve good symptom control.