Malignant Transformation of Intra-cranial Epithelial Cysts: Systematic Article Review

Overview

Journal J Neurooncol

Publisher Springer

Date 2005 Sep 30

PMID 16193391

Citations 42

Authors

Abderrahmane Hamlat

Zhi-Fen Hua

Stephan Saikali

Jean Francois Laurent

Daniel Gedouin

Mohamed Ben-Hassel

Yvon Guegan

Affiliations

Soon will be listed here.

Abstract

Introduction: Epidermoid and dermoid cysts are among the most benign intra cranial tumors. Their malignant transformation into squamous cell carcinoma is rare. The authors reviewed the literature.

Materials And Methods: MEDLINE and SCIENCE DIRECT searches, and examination of the references in the selected articles yielded 74 patients, 52 of whom fulfilled Garcia's criteria and were selected for the study. Survival analyses were performed to determine whether survival differences were of statistical significance, and P < 0.05 was considered as significant.

Results: Malignant transformation is characterized by a rapid onset of symptoms, recurrence, leptomeningeal carcinomatosis (LC), and tumor enhancement at Computed Tomography Scan or Magnetic Resonance Imaging (87.8 showed this radiological feature). In this review, the SCCs were classified in five groups: (1) Initial malignant transformation of a benign cyst; (2) malignant transformation from a remnant cyst; (3) malignant transformation of a dermoid and epithelial cyst; (4) malignant transformation with leptomeningeal carcinomatosis; (5) other malignancies arising from benign cysts. The median survival was 9 months. Statistics show that LC was of poor prognosis and radiotherapy, although not statistically significant, seems effective against such lesions, with a median survival of 26 months as opposed to 3 months (P=0.077).

Conclusion: Although rare, malignant transformation of intracranial epithelial cysts has a poor prognosis and surgery followed by radiotherapy seems to be the best therapeutic modality.

Citing Articles

Intracranial epidermoid cyst with malignant degeneration and leptomeningeal carcinomatosis: illustrative case.

Alsadi H, Dahlstrom K, Summers K, Camarata P, Werth K J Neurosurg Case Lessons. 2025; 9(5).

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Dorsal midbrain squamous cell carcinoma: Case report and review of literature.

Dey S, Debanath A Med J Armed Forces India. 2024; 80(Suppl 1):S264-S267.

PMID: 39734864 PMC: 11670550. DOI: 10.1016/j.mjafi.2023.01.005.

Microscopic and neuroendoscopic treatment of a large ruptured supratentorial dermoid cyst with extensive dissemination: a case report and literature review.

Zhang Y, Deng T, Wu Z, Yang H, Ma X, Wang Y Front Oncol. 2024; 14:1468622.

PMID: 39469639 PMC: 11513383. DOI: 10.3389/fonc.2024.1468622.

The Riddle of the Double Vision-A Rare Case of Intracranial Tumor: When Imaging Resolves the Mystery.

Kirkova R, Dineva S, Stradiotto E, Tanev I, Di Maria A Diagnostics (Basel). 2024; 14(9).

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The imaging dynamic changes in the malignant transformation of an epidermoid cyst: a case report and literature review.

Yang T, Hu J, Li L, Xu H, Zhang C, Huang Z Front Neurol. 2024; 15:1349044.

PMID: 38419698 PMC: 10900506. DOI: 10.3389/fneur.2024.1349044.

References

Shirabe T, Fukuoka K, Watanabe A, Imamura K, Ishii R . Primary squamous cell carcinoma of the brain. A rare autopsy case. Neuropathology. 2003; 23(3):225-9. DOI: 10.1046/j.1440-1789.2003.00499.x. View

Khan R, Giri D, Rosenblum M, Petito F, DeAngelis L . Leptomeningeal metastasis from an intracranial epidermoid cyst. Neurology. 2001; 56(10):1419-20. DOI: 10.1212/wnl.56.10.1419. View

Kompf D, Menges H . [Malignant degeneration in a parapontine epidermoid (author's transl)]. Acta Neurochir (Wien). 1977; 39(1-2):81-90. DOI: 10.1007/BF01405245. View

Fuse T, Takagi T, Mizuno S, Yamada K . [Primary intracranial malignant epidermoid--case report]. No To Shinkei. 1995; 47(10):997-1001. View

Matsuno A, Shibui S, Ochiai C, Inoya H, Takakura K . [Primary intracranial epidermoid carcinoma accompanied with epidermoid cyst in the cerebellopontine angle--a case report]. No Shinkei Geka. 1987; 15(8):851-8. View

Link M, Cohen P, Breneman J, Tew Jr J . Malignant squamous degeneration of a cerebellopontine angle epidermoid tumor. Case report. J Neurosurg. 2002; 97(5):1237-43. DOI: 10.3171/jns.2002.97.5.1237. View

Suzuki F, Konuma I, Matsumoto M, Aoki M, Hayakawa I . [Craniopharyngioma with malignant transformation--a report of two cases]. Gan No Rinsho. 1989; 35(6):723-8. View

GLUSZCZ A . A cancer arising in a dermoid of the brain. A case report. J Neuropathol Exp Neurol. 1962; 21:383-7. DOI: 10.1097/00005072-196207000-00006. View

Poptani H, Gupta R, Jain V, Roy R, Pandey R . Cystic intracranial mass lesions: possible role of in vivo MR spectroscopy in its differential diagnosis. Magn Reson Imaging. 1995; 13(7):1019-29. DOI: 10.1016/0730-725x(95)00045-i. View

10.

Knorr J, Ragland R, Smith T, Davidson R, KELLER J . Squamous carcinoma arising in a cerebellopontine angle epidermoid: CT and MR findings. AJNR Am J Neuroradiol. 1991; 12(6):1182-4. PMC: 8331491. View

11.

Wagner J, FROST J, WISOTZKEY Jr H . Subarachnoid neoplasia: incidence and problems of diagnosis. South Med J. 1960; 53:1503-8. View

12.

Uchino A, Hasuo K, Matsumoto S, Uda K, Moriguchi M, Nishio T . Intracranial epidermoid carcinoma: CT and MRI. Neuroradiology. 1995; 37(2):155-8. DOI: 10.1007/BF00588635. View

13.

Sahara Y, Nagasaka T, Takayasu M, Takagi T, Hata N, Yoshida J . Recurrence of a neurenteric cyst with malignant transformation in the foramen magnum after total resection. Case report. J Neurosurg. 2002; 95(2):341-5. DOI: 10.3171/jns.2001.95.2.0341. View

14.

Bondeson L, Falt K . Primary intracranial epidermoid carcinoma. Acta Cytol. 1984; 28(4):487-9. View

15.

Lewis A, Cooper P, Kassel E, Schwartz M . Squamous cell carcinoma arising in a suprasellar epidermoid cyst. Case report. J Neurosurg. 1983; 59(3):538-41. DOI: 10.3171/jns.1983.59.3.0538. View

16.

Giangaspero F, Manetto V, Ferracini R, Piazza G . Squamous cell carcinoma of the brain with sarcoma-like stroma. Virchows Arch A Pathol Anat Histopathol. 1984; 402(4):459-64. DOI: 10.1007/BF00734642. View

17.

Monaco R, Boscaino A, Di Blasi A, DAntonio A, Profeta G, de Falco R . Intraepithelial carcinoma arising in an endodermal cyst of the posterior fossa. Neuropathology. 2003; 23(3):219-24. DOI: 10.1046/j.1440-1789.2003.00497.x. View

18.

Tsugu H, Fukushima T, Hayashi S, Iwaasa M, Matsuda T . Squamous cell carcinoma arising in an intracranial dermoid cyst--case report. Neurol Med Chir (Tokyo). 2001; 41(4):213-6. DOI: 10.2176/nmc.41.213. View

19.

TOGLIA J, NETSKY M, ALEXANDER Jr E . Epithelial (epidermoid) tumors of the cranium. Their common nature and pathogenesis. J Neurosurg. 1965; 23(4):384-93. DOI: 10.3171/jns.1965.23.4.0384. View

20.

Murase S, Yamakawa H, Ohkuma A, Sumi Y, Kajiwara M, Takami T . Primary intracranial squamous cell carcinoma--case report. Neurol Med Chir (Tokyo). 1999; 39(1):49-54. DOI: 10.2176/nmc.39.49. View