What are the other Names for this Condition? (Also known as/Symptoms)

• Dermoid Brain Cyst
• Intracranial Dermoid Cyst

What is Dermoid Cyst of Brain? (Definition/Background Information)

• Dermoid Cyst of Brain is a benign slow-growing tumor that is generally found at the base of the skull or behind the nose bridge. It usually consists of a single cyst filled with sebaceous material. A dermoid cyst has only hair, skin, and adnexal structures in the cyst wall and contents
• In general, a dermoid cyst may be described as a type of mature cystic teratoma. A teratoma is a rare tumor that arises from the germ cells. Teratomas are typically classified as either mature teratomas or immature teratomas
• The cause of formation of a Dermoid Cyst of Brain is unknown. Also, presently, the risk factors for the same are not well-established. This rare cystic tumor is usually seen in children; it is believed to develop during pregnancy, in the fetal stage
• In many individuals, a Dermoid Brain Cyst does not present any significant signs and symptoms, and these tumors are diagnosed incidentally. Some tumors may cause headaches, nausea and vomiting, or vision impairment, if the optic nerve is involved
• In some cases, the treatment of Dermoid Cyst of Brain may involve surgery. In a majority of cases, the prognosis is good with appropriate early treatment, since it is a benign tumor. However, some tumors may undergo a malignant transformation. In such cases, the prognosis depends upon several factors including on the tumor stage

Who gets Dermoid Cyst of Brain? (Age and Sex Distribution)

• Dermoid Cysts of Brain are uncommon tumors that represent 0.5% of all intracranial tumors
• These cysts are mostly observed in children. Some are known to be present from birth
• A slight female predilection is noted, even though both males and females are affected
• No specific racial or ethnic group predilection is noted

What are the Risk Factors for Dermoid Cyst of Brain? (Predisposing Factors)

• Currently, no definite risk factors have been identified for Dermoid Cyst of Brain

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Dermoid Cyst of Brain? (Etiology)

• The cause of development of Dermoid Cyst of Brain is generally unknown. It is believed that abnormal differentiation of germ cells gives rise to the formation of this cyst
• The abnormal germ cell differentiation gives rise to skin and adnexal structures. This occurs while the baby is in the mother’s womb (and congenital manifestation is noted)

The condition is not caused by what the expectant mother does or does not do, either prior to or during pregnancy.

What are the Signs and Symptoms of Dermoid Cyst of Brain?

The signs and symptoms of Dermoid Cyst of Brain can vary from one individual to another and depends on the size and location of the cystic tumor. In general, most small tumors are asymptomatic and no significant symptoms are observed, while large tumors are known to present symptoms. In many individuals, tumors that grow slowly and remain asymptomatic, are only diagnosed during certain radiological imaging studies of the head and neck region, which are performed for unrelated health conditions.

Within the brain, the tumors are found in the fourth ventricle cavity, the posterior fossa, and under the frontal lobes, nearer to the nose bridge. Dermoid cysts that involve the bridge of the nose are termed nasal dermoid cysts. Extremely rarely, these are also noted in the spinal cord and are termed spinal dermoid cysts.

The signs and symptoms of Dermoid Cyst of Brain may rarely include:

• Presence of a well-circumscribed cystic (fluid-filled) tumor mass
• Headaches
• Vision impairment, if the optic nerve is affected
• Hearing impairment
• Numbness and tingling sensation
• Muscle weakness
• Movement difficulties
• Dizziness
• These cysts are known to form sinus tracts between the brain and outer skin surfaces

How is Dermoid Cyst of Brain Diagnosed?

There are a variety of tests the healthcare provider may employ to diagnose Dermoid Cyst of Brain, which may include:

• Physical examination and complete medical history screening
• Assessment of the presenting signs and symptoms
• Neurological, motor skills, and cognitive assessment:
  • Checking intellectual ability, memory, mental health and function, language skills, judgment and reasoning, coordination and balance, reflexes, and sensory perceptions (space, sight, hearing, touch, etc.)
  • The healthcare provider/neurologist may use the Karnofsky Performance Scale in order to assess the neurological functioning of the individual’s central nervous system (CNS)
• Electroencephalography (EEG)
• Electromyography with nerve conductivity tests
• Imaging studies that may be performed include:
  • X-ray of head and neck region
  • Computerized tomography (CT) scan of the head and neck region; CT with contrast
  • Magnetic resonance imaging (MRI) scan of the brain; MRI with contrast agents such as gadolinium
  • Cerebral angiographic studies or MR angiography: An angiogram involves injecting dye into the bloodstream, which makes the blood vessels to appear visually on X-rays. The X-ray may show a tumor in the brain or the blood vessels leading into the tumor
  • Magnetic resonance spectroscopy: This radiological technique is used to study the chemical profile of the tumor. It is often performed with and compared to corresponding MRI scan images of the affected region
• Cerebrospinal fluid analysis, where a spinal tap or lumbar puncture procedure may be performed: This diagnostic test is used to remove a sample of cerebrospinal fluid (CSF) from the spaces in and around the brain and spinal cord. The sample is removed from the lower spinal cord using a thin needle, and it is then checked for the presence of cancer cells
• Molecular studies, if necessary

Tissue biopsy: A biopsy of the affected region (brain or spinal cord) is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy sample under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy sample under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis.

A differential diagnosis to eliminate other conditions or tumor types may be considered, before arriving at a definitive diagnosis.

The radiological differential diagnosis may include:

• Craniopharyngioma
• Intracranial epidermoid cyst
• Intracranial lipoma
• Intracranial teratoma

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Dermoid Cyst of Brain?

The complications of Dermoid Cyst of Brain may include the following:

• Stress and anxiety due to fear of an intracranial tumor
• Large tumor masses may get secondarily infected with bacteria or fungus
• Tumor rupture and torsion: Usually, larger tumors are more prone for torsion
• Tumor rupture may cause a form of meningitis, called chemical meningitis
• Occasionally, recurrence of the tumor following its incomplete surgical removal
• Some teratomas are known to rarely transform to malignancies; the most common cancer arising from a mature cystic teratoma is a squamous cell carcinoma
• Damage to the muscles, vital nerves, and blood vessels, during surgery
• Post-surgical infection at the wound site is a potential complication

How is Dermoid Cyst of Brain Treated?

The treatment of Dermoid Cyst of Brain may involve the following:

• In some cases of small-sized tumors with slow-growing rates, the healthcare provider may consider conservative ‘wait and watch’ measures, instead of immediately recommending surgery to remove them
• Generally, the treatment of choice is a complete surgical excision for all such tumors (mature or immature teratomas). The surgeon may perform a craniotomy or use other microsurgical approaches to remove the cyst
• Additionally, chemotherapy and/or radiation therapy may be necessary for malignant tumors
• Follow-up care with regular screening and check-ups are important and encouraged

How can Dermoid Cyst of Brain be Prevented?

Currently, there are no known methods to prevent the development of Dermoid Cyst of Brain.

What is the Prognosis of Dermoid Cyst of Brain? (Outcome/Resolutions)

• The prognosis of Dermoid Cyst of Brain is usually good with complete surgical removal of the tumor, since it is predominantly a benign tumor
• In case of a malignant transformation of a mature benign tumor to a cancerous teratoma, the prognosis depends on several factors including on the stage of the tumor

Additional and Relevant Useful Information for Dermoid Cyst of Brain:

The following article link will help you understand other cancers and benign tumors:

http://www.dovemed.com/diseases-conditions/cancer/