Intradiploic epidermoid cyst with intracranial hypertension syndrome: Report of two cases and literature review

• Epidermoid cysts are benign tumors -IEIC-that originate in the spine or intracraneally.
• Intradural compose 75% of epidermoid cysts and 25% are extradural in the diploic space—IEIC.
• These benign lesions although they are of low incidence, are seen very rarely in intradiploic locations and above all, of significant size, may produce significant mass effect in patients, which was initially tolerated because of its slow growth, however, they may become decompensate and cause intracranial hypertension syndrome.

IntroductionIntradiploic epidermoid intracranial cysts (IEIC) derive from ectodermal cells and are covered with stratified squamous epithelium. They are extremely rare, and most common locations are in the occipital, frontal and parietal bones. They have a very slow growth and can be asymptomatic until becoming evident by the deformation produced. The treatment is based on the removal of the lesion, and subsequent histopathological confirmation.Presentation of caseTwo cases are reported, with intracranial hypertension syndrome, which is very uncommon because of the slow growth of this type of pathology; however, decompensations occurring in the space-occupying lesions at intracranial level explain this type of clinical presentation.DiscussionThe most common presentation of intracranial intradiploic epidermoid cysts (IEIC) is asymptomatically, which is made evident by the prominence at the level of the soft tissues and then presenting less frequently local pain and cephalea; rarely the size of the lesion can cause focal neurological signs.ConclusionThese benign lesions, although they are of low incidence, are seen very rarely in intradiploic locations and above all, of significant size, may produce significant mass effect in patients, which was initially tolerated because of its slow growth, however, they may become decompensate and cause intracranial hypertension syndrome.