PMC3707326_01
Noncontrast CT scan of the head shows a heterogeneous low attenuation lesion extending from the floor of the anterior cranial fossa superiorly along the falx, with diffuse scattered areas of low-attenuation throughout the subarachnoid space and lateral ventricles
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F1
Fat-fluid levels were present throughout the ventricular system, with evidence of obstructive hydrocephalus [Figures 1 and 2].
Preoperative sagittal and coronal T1 MRI of the brain (a and b) shows a large T1 hyperintense multilobulated lesion extending along the floor of the left anterior and middle cranial fossa, with areas of T1 hypointense signal around the component in the left anterior cranial fossa. Locules of T1 hyperintense material are present throughout the subarachnoid spaces along the sylvian fissures bilaterally, extending into the frontal sulci, parasagittal frontal lobes, tectum, and into the posterior fossa. Fat-fluid levels are present within the ventricular system, with evidence of obstructive hydrocephalus
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F2
Fat-fluid levels were present throughout the ventricular system, with evidence of obstructive hydrocephalus [Figures 1 and 2].
Postoperative sagittal and coronal MRI of the brain (a and b) with evidence of gross total resection of the dermoid cyst along the anterior cranial fossa floor, with residual intraventricular and subarachnoid fat droplets
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F3
A ventricular catheter was placed and externalized to allow residual fat droplets and sebaceous material in the ventricular system a path to exit the cranium [Figure 3].
Histopathologic examination. Hematoxylin and eosin (H and E) stained sections x40, x100, and x40, respectively, showing the typical histologic components of the dermoid cyst
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F4
Histo-pathologic examination of the surgical specimens showed the wall of a ruptured dermoid cyst, with the typical squamous epithelial lining, and dispersed pilosebaceous units (hair follicles and associated sebaceous glands) with some focal calcification [Figure 4].