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July 1990

Intracranial Epidermoid Tumors: A Continuing Diagnostic Challenge

Author Affiliations

From the Neurosurgical Service (Drs Panagopoulos, El-Azouzi, and Black), Department of Radiology (Drs Chisholm and Jolesz), Brigham and Women's Hospital; Department of Neurosurgery, the Children's Hospital (Drs Panagopoulos, ElAzouzi, and Black); and Departments of Surgery (Drs Panagopoulos, El-Azouzi, and Black) and Radiology (Drs Chisholm and Jolesz), Harvard Medical School, Boston, Mass.

Arch Neurol. 1990;47(7):813-816. doi:10.1001/archneur.1990.00530070111020

• Epidermoid tumors are benign, slowly growing intracranial masses that still present difficulty in preoperative diagnosis. This article reviews six cases of histologically proven epidermoid tumors. Computed tomography and magnetic resonance imaging were complementary in their evaluation. Computed tomography demonstrated a hypodense, smoothly contoured extra-axial paramedian mass with lower density than cerebrospinal fluid. Magnetic resonance imaging usually demonstrated an irregularly but sharply marginated mass with inhomogeneous density, variable enhancement with gadolinium, lack of edema in adjacent normal structures, extensive insinuation into cisternal and other cerebrospinal fluid spaces, and a high-signal intensity on proton-weighted images. Multiplanar magnetic resonance imaging was extremely helpful in displaying the full anatomic extent of the lesion and its relationship with other structures.

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