PMC9990783_01
Initial magnetic resonance imaging MR images show hypointense in T1 (a), hyperintense in T2 (b), with restricted diffusion on DWI (c). Fat droplets in the subarachnoid space nearby the tumor was also noted (arrowhead). (d and e): The coronal and sagittal images with gadolinium shows the slight enhancement of the tumor capsule and also the mass locating both intradurally and extradurally at foramen ovale.
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F1
It appeared restricted on diffusion-weighted imaging with a hypointense signal in T1 and hyperintense in T2, coupled with fat droplet presence in the nearby basal subarachnoid region [Figure 1]. In addition, minor enhancement of the capsule on the coronal and sagittal pictures was apparent [Figures 1c and d].
Chronological magnetic resonance imaging (MRI) changes in a patient after traumatic rupture of dermoid cyst Upper: The initial MRI showing fat droplets in the adjacent collateral sulcus. Middle: 11 months later, MRI shows migration into the posterior part of the collateral sulcus and quadrigeminal cistern (not shown in this view). Lower: Final MRI showing the fat droplet further migrates into the third ventricle.
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F2
A serial brain MRI [Figure 2] over 24 months disclosed a significant alteration in the extent of the dermoid cyst's ruptured status, which is the continual migration of fat droplets inside the subarachnoid space from the collateral sulcus.
Intraoperative microscopic photos (a) Extradural part of dermoid cyst. FO: Enlarged foramen ovale, FS: Foramen spinosum. (b) Intradural part of the dermoid with a fat droplet (arrowhead).
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F3
Hence, we performed complete surgical resection through a combined extradural and intradural right subtemporal approach [Figure 3].
Histopathological findings (hematoxylin and eosin staining) (a) fatty tissue and collagen fibers (b) hair shafts (arrowheads) and keratin debris (arrow).
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F4
The histological finding confirmed the dermoid cyst [Figure 4] and the proceeding MRI verified the entire resection with no evidence of ventricular dilation [Figure 5].
One-month postoperative magnetic resonance imaging images show complete removal of the ruptured dermoid cyst, with fat droplets in the subarachnoid space, no change in their sites, and no hydrocephalus.
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F5
The histological finding confirmed the dermoid cyst [Figure 4] and the proceeding MRI verified the entire resection with no evidence of ventricular dilation [Figure 5].