doiSerbia

Surgical treatment of intradiploic epidermoid cyst treated as depression

Živković Nenad (Department of Neurosurgery, Clinical Hospital Center Zemun, Belgrade + Faculty of Medicine, Belgrade)
Marković Marko (Department of Neurosurgery, Clinical Hospital Center Zemun, Belgrade + Faculty of Medicine, Belgrade)
Mihajlović Goran (Clinic for Psychiatry, Clinical Center, Kragujevac + Faculty of Medical Sciences, Kragujevac)
Jovanović Milan (Otorhinolaryngology Department, Clinical Hospital Center Zemun, Belgrade)

Introduction. Extradural intradiploic epidermoid cysts are rare, representing less than 0.25% of all primary intracranial tumors. They can be neurologically silent and can only present psychiatric symptoms like depression, cognitive or personality changes. Case Outline. A 68-year-old male with two year long history of depressive mood, lack of motivation, helplessness, hopelessness and poor response to antidepressive drug therapy was described. CT scan showed a well-defined mass in the parietal scalp with destruction of the scull. He underwent intracranial tumor resection. Surgical resection and cranioplasty were performed. Pathology confirmed intradiploic epidermoid cyst. Conclusion. Total removal of these cysts and repeated washing of the cavity with 0.9 % saline may prevent recurrence and aseptic meningitis and may improve mental state of the patient. We also emphasize the need for neuroimaging studies in a patient with atypical changes in mental status, even without neurological signs or symptoms.

Keywords: epidermoid cyst, brain tumor, depression