Malignant Transformation of Intracranial Epidermoid Cyst to Squamous Cell Carcinoma, Case Report and Literature Review

Abstract

Intracranial Epidermoid cysts (ECs) are rare, benign tumor of central nervous system that appears from maintain ectodermal implants. Malignant transformation of an EC to squamous-cell carcinoma (SCC) is rarely reported. Intracranial squamous cell carcinoma has known as a poor prognosis condition that optimal modalities remain uncertain. We present the case of 43-years old male complained 3 months severe headache and right eye hemianopia. Primary evaluation depicted right homogenous brain mass which was successfully totally removed. Pathological assessment found epidermoid cyst without any sign of malignancy. Six months later, patient was referred with episodes of intermittent headache and right eye blindness. After initial imaging, new tumor was growth in same site of frontal epidermoid cyst. Second surgery was performed and pathological report discloses to be a malignant SCC. SCC transformation was confirmed by two expert neuro- pathologists. The exact underlying mechanism causing malignant transformation is not definitely known and it seems SCC may have been transformed due to chronic inflammatory respond to epidermoid cyst. Literature reviews demonstrate that, although, optimal total resection in addition adjuvant radiotherapy is the recommended management of choice, patient’s general survival of this condition is generally poor and long-term follow-up is important.