Objective: Supratentorial dermoid cysts are unusual benign mass lesions in pediatric patients, especially if located in a lateralized position such as in the lateral sulcus. Since these lesions often adhere tightly to circumjacent nerves or vessels, preoperative evaluation is important. Here we report on a pediatric patient with an intrasylvian dermoid cyst who underwent radical microsurgical resection and review the relevant literature.
Methods: An 8-year-old girl with a cystic space-occupying lesion in the right lateral sulcus was referred to our hospital. The lesion appeared similar to CSF on T1/T2 sequences on magnetic resonance imaging(MRI). However, diffusion-weighted imaging(DWI)indicated high diffusion restriction. During the operation, dermal appendage was found within the tumor capsule. Gross total resection was achieved and the patient was discharged without any deficits. Histological findings confirmed the diagnosis of a dermoid cyst.
Discussion: Only three cases of pediatric patients with dermoid cysts located in the lateral sulcus have been described. Due to its rarity and highly variable appearance on MRI, obtaining a differential diagnosis is difficult. Gross total resection should be the surgical goal;nevertheless, adjacent structures must be preserved.
Conclusion: Here we described an additional rare case of intrasylvian dermoid cyst in childhood. The appearance of such cysts on DWI can aid with their preoperative diagnosis.