Large intradiploic epidermoid tumor of the skull: Case report and review of literature

Background: A rare case of a large intradiploic epidermoid tumor of the parietal bone is described and recent literature pertaining to radiological evaluation and the surgical treatment of these lesions is reviewed. Methods: A 70-year-old female patient was noted to have a painless subcutaneous swelling 15 years ago. She currently presented with complaints of unsteady gait, occasional episodes of vertigo, tinnitus and a constant fear of falling. Evaluation with a Computed Tomographic scan (CT) and Magnetic Resonance Imaging (MRI) revealed an epidural non-enhancing mass in the mid-parietal region, extending into the Sylvian fissure, medially and laterally. The patient underwent a computer-assisted stereotactic craniotomy followed by a total microsurgical resection of the tumor. The large cranial defect produced by the tumor resection was repaired with a titanium wire mesh and methyl methacrylate cranioplasty. Result: The patient had an uneventful post-operative course and was discharged home in good condition. A review of the literature shows that intradiploic epidermoid tumors of the parietal bone are rare. Complete resection without adjuvant therapy is the mainstay of treatment. Conclusion: Correct radiological assessment and complete excision of these lesions and their capsules can reduce the risk of recurrence and prevent the lesion from undergoing malignant transformation. Total removal of the tumors is associated with a very good long-term prognosis. Epidermoid Tumor of the Skull.