intradiploic epidermoid cyst

Intradiploic epidermoid cysts represent epidermoid cysts that occur in the diploë of the skull.
Clinical presentation
Painless slowly progressive scalp swelling.
Pathology
- epidermoid cysts may be congenital (most common, arising from ectodermal inclusion during neural tube closure and subsequently remain within the cranial bones) or acquired (e.g. post-surgical or post-traumatic implantation)
- intradiploic epidermoids are less frequent than the intradural variety
Radiographic features
Intradiploic epidermoids occurs within the frontal, parietal, occipital and sphenoid bones, as well as the spine .
Plain radiograph
- rounded or lobulated area of bone destruction, well-delineated sclerotic scalloped margins
CT
- non-enhancing hypodense lesion with sharply demarcated bony defects and zones of calcifications
- it may alter the outer and/or inner tables of the skull (the inner table more than the outer)
MRI
- T1: slightly hyperintense to the CSF
- T2: isointense/hyperintense to the CSF
- FLAIR: hyperintense to the CSF space
- DWI: restricted diffusion with characteristic hyperintensity
- T1C+: none
History and etymology
The first intradiploic epidermoid cyst was reported by J Müller in 1838 .
The radiological pattern of intradiploic epidermoids was first described by Cushing in 1922.
Differential diagnosis
Consider:
- eosinophilic granuloma
- calvarial hemangioma
- dermoid cyst
- fibrous dysplasia
Siehe auch:
