What is an epidermoid cyst?
An epidermoid cyst is a congenital (present at birth) pocket of misplaced tissue made of skin-like cells. Epidermoid cysts can occur in many places in the body - including inside the skull. They can behave like benign brain tumors, growing slowly over time. They are not cancerous, but they can cause problems when they start to compress the brain or surrounding nerves.
What are the symptoms?
Symptoms from an epidermoid cyst depend on the location of the cyst and the structures that it presses on. For example, a common location for epidermoid cysts is the space between the brainstem and the skull, where a cyst might compress nerves and cause facial twitching, numbness, or pain, ringing in the ears, vision loss or double vision, or hearing loss. Other more general symptoms might include headaches, nausea, and even meningitis.
Does an epidermoid cyst need treatment?
Small epidermoid cysts often do not need treatment and can be watched over time with MRI scans. If an epidermoid cyst is large or causing symptoms, treatment should be considered. The standard treatment is removal by craniotomy. In this procedure, the skull is opened to suck out the cyst.
My guide to craniotomy for brain tumor or lesion describes the procedure in detail.
Can an epidermoid cyst grow back?
Although epidermoid cysts are not cancerous, they tend to grow back slowly. For recurrent epidermoid cysts and for some patients who are not candidates for craniotomy, non-invasive therapies like Gamma Knife can be effective.
My Gamma Knife patient guide describes the procedure in detail.
How is treatment chosen?
Whether and how to treat your epidermoid cyst depend on a number of factors, including the size, location, and symptoms, along with your age and overall health.
Should I meet with you?
If you have a brain epidermoid cyst, please consider meeting me in consultation to discuss your options.