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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2018; 37(04): 339-342
DOI: 10.1055/s-0038-1676530
Case Report | Relato de Caso
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

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

Ressecção microcirúrgica de cisto dermoide pela abordagem extremo-lateral: relato de caso e revisão da literatura
Lucas Crociati Meguins
1   Departament of Neurologic Sciences, Hospital de Base, São José do Rio Preto, São Paulo, Brazil
,
Antonio Ronaldo Spotti
1   Departament of Neurologic Sciences, Hospital de Base, São José do Rio Preto, São Paulo, Brazil
,
Dionei Freitas de Morais
1   Departament of Neurologic Sciences, Hospital de Base, São José do Rio Preto, São Paulo, Brazil
,
Carlos Eduardo Dall'Aglio Rocha
1   Departament of Neurologic Sciences, Hospital de Base, São José do Rio Preto, São Paulo, Brazil
,
Ricardo Lourenço Caramanti
1   Departament of Neurologic Sciences, Hospital de Base, São José do Rio Preto, São Paulo, Brazil
,
Mario José Góes
1   Departament of Neurologic Sciences, Hospital de Base, São José do Rio Preto, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

10 July 2018

30 October 2018

Publication Date:
12 December 2018 (online)

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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.

Resumo

Introdução Tumores dermoides intracraniais são casos clínicos raros que representam de 0,04 a 0,6% de todos os tumores intracraniais. Sua localização na fossa posterior é incomum.

Objetivos Relatar o caso de uma jovem com cisto dermoide na fossa posterior tratado pela lateral direita.

Relato de Caso Paciente de 17 anos apresentando dificuldades de engolir há seis meses encaminhada para investigação neurológica. Imagem de ressonância magnética mostrou uma lesão larga hipertensa T1 ocupando a fossa posterior e comprimindo a face anterior do tronco cerebral e cerebelo. A paciente foi submetida a tratamento cirúrgico pela abordagem extremo-lateral direita com descompressão das estruturas vascular e neural. A paciente apresentou rápida melhora e recebeu alta 4 dias após o procedimento sem nenhum déficit neurológico. A análise anatomopatológica confirmou o diagnóstico de cisto dermoide.

Conclusão A abordagem extremo-lateral direita é o acesso mais seguro e factível para tratar apropriadamente largos cistos dermoides na fossa posterior. Descompressão das estruturas vascular e neural é fundamental para alcançar bom controle sintomático.

Keywords

dermoid cyst - far lateral approach

Palavras-chave

cisto dermoide - abordagem extremo-lateral
 

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