Epidermoid.com

The epidermoid is a benign (i.e., non-cancerous) neoplasm or mass located in the brain. It is generally believed to be congenital and occurs when skin cells that are wrongly deposited during neural tube closure causing so-called ectodermal elements to be trapped. Epidermoids consist of an outer covering — the capsule part — and of an inner mixture of skin cells and fatty acids. The capsule is about the thickness of wet tissue paper and the inside contents are the consistency of cottage cheese. These tumors are slow growing and generally are diagnosed in the middle twenties to the late fifties. They do grow, but at a slow rate, and if not removed entirely, tend to grow back. The most common sites in the brain for these tumors are the cerebellopontine angle and the pituitary area. In surgery removal part of the capsule must often be left in because of adhesion to cranial nerves or the brain stem. The incidence of intracranial epidermoids is between 0.2% to 1.8% of all brain tumors. They can also be found on the brain stem in extremely rare instances.

In a recent study of 54 patients operated on for epidermoids of the brain and followed for a thirteen year period, the authors derived the following statistics: Fifty-seven percent of the tumors were completely removed. A higher total removal rate was achieved in patients with tumors confined to the primary location. Three percent died in the preoperative period. Approximately half of the patients presented with transient mild focal deficit impairments resulting from manipulation of the nervous structure over a wide area. There was a higher rate of surgical complications with fourth ventricle and mesencephalic extended CPA tumors. The mean follow-up period was 8.6 years. Thirty percent of the patients with subtotal removal experienced symptomatic recurrences after 8.1 years, whereas all patients with total removal were still asymptomatic. The recurrence-free survival rate was 95% at 13 years for patients with total removal compared with 65% for patients with subtotal removal (Neurosurgery, 1998 Feb, 42:2, 242-51).

These epidermoid tumors have also been referred to in the literature as epidermoid cysts, epidermoid lesions, intercranial cholesteatoma, pearly tumor, or tumeur perlee (French). Cholesteatomas are an older name and now considered a misnomer. They are also found in the ear, some being congenital, and some acquired.

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Source: epidermoidbraintumor.org

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