|Patient: 1 year 7 month old male|
| History: |
19-month-old with acute onset altered mental status
|Findings: Parasagittal midline T1 shows mixed signal intensity mass centered within the posterior third ventricle/pineal region. There is obstructive hydrocephalus and a fat-fluid level within the lateral ventricle. Scattered fat droplets are seen within the subarachnoid spaces.|
| Diagnosis: |
Ruptured 3rd ventricle dermoid cyst. DDx: Ruptured pineal teratoma.
| Discussion: |
Intracranial dermoids are congenital inclusion cysts, containing various dermal elements. They are rare and comprise < 1% of primary intracranial tumors. Age of presentation 30-50y. HA and CN mass effect usual presentation. Rupture with chemical meningitis occurs in only 7%. This patient demonstrates typical appearance of rupture with intraventricular and subarachnoid extension.
Occipital/nasofrontal dermal sinus
Goldenhar syndrome (oculoauriculovertebral dysplasia)
Usually near midline, in contrast to epidermoid cyst
Fat, calcification, soft tissue – use fat suppression
Enhancement with chemical meningitis
DDx midline masses:
Rupture 7%, meningitis, vasospasm
Recurrence following excision
Malignant degeneration reported
| References: |
Osborn AG, et al. Diagnostic imaging: brain. Amirsys, 2005.
| Comments: |
No comments posted.
| Additional Details:|
Case Number: 3607626Last Updated: 01-09-2006 The reader is fully responsible for confirming the accuracy of this content.
The reader is fully responsible for confirming the accuracy of this content.