Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc
Journal website http://www.neurores.org

Case Report

Volume 7, Number 1-2, April 2017, pages 19-23

Sylvian Fissure Epidermoid Tumor Presenting With Intractable Non-Pulsatile Tinnitus

Figures

Figure 1.
Figure 1. Preoperative MRI scan of the brain demonstrated a large right Sylvian epidermoid tumor. The lesion demonstrated a hypointense signal on para-sagittal T1-WI (a) and coronal (b) T2-FLAIR sequences, hyperintense signal on axial T2-WI (c) and axial DWI (d) MRI scan. There was no enhancement of the hypointense lesion following IV contrast as demonstrated on axial (e) and coronal (f) T1-WI MRI scan.
Figure 2.
Figure 2. Microscopic photograph at surgery after right frontotemporal craniotomy and dural opening demonstrating an epidermoid tumor with characteristic “pearl” contents. The middle cerebral artery branches were found displaced and adherent to the wall of the cystic tumor (arrowheads).
Figure 3.
Figure 3. Histopathological microphotograph demonstrating a stratified epithelium wall (black arrow) containing keratin and cholesterol (yellow arrowhead) characteristics of an epidermoid cyst, and surrounding inflammatory cells and gliosis (blue arrowhead) (hematoxylin and eosin stain, × 100 magnification).
Figure 4.
Figure 4. Postoperative MRI scan of the brain at 1 year follow up demonstrated complete resection of the epidermoid tumor as evidenced as a hypointense signal on para-sagittal T1-WI (a) and coronal (b) T2-FLAIR sequences, marked decrease hyperintense signal on axial T2-WI (c) and axial DWI (d) images. There were no vascular complications or enhancement of the hypointense lesion following IV contrast as demonstrated on axial (e) and coronal (f) T1-WI MRI scan.