Surgical strategy for dermoid and epidermoid tumors of the posterior fossa. Experience with 21 patients

Introduction: The aim of this paper is to describe on our surgical strategy and technique and to identify the best management option for Posterior Fossa Dermoid and Epidermoid Tumors. Despite the development of microsurgery and cranial base techniques, the surgical management of IDETs continues to be a formidable technical challenge to neurosurgeons because these tumors grow in close contact with neural and vascular structures that cannot be sacrificed or retracted.

Methods: We retrospectively identified twenty-one consecutive patients (eleven males and ten females; mean age at surgery, 33.2 years), with pathologically confirmed Posterior Fossa Dermoid or Epidermoid Tumors, who underwent surgical resection. The mean follow-up was of 9.1 years.

Results: Gross total tumor removal was achieved in sixteen cases (76.1%). We had no surgical mortality. The recurrence rate was 9.5%.

Conclusions: The surgical strategies used in this group of patients enabled total removal of most tumors without surgical mortality and with minimal morbidity and recurrence rates. In this series, the extended retrosigmoid approach was used for large, giant or in multidepartment’s tumors. Our surgical strategies proves to be safe and effective.