Child dermoid cyst mimicking a craniopharyngioma: the benefit of MRI T2-weighted diffusion sequence
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Brain dermoid cysts are very rare lesions. Although benign, these cysts may be associated with devastating complications due to mass effect or meningitis. The discovery of completely asymptomatic dermoid cysts in the pediatric population is exceedingly rare. Despite the advances in imaging modalities, it sometimes remains difficult to exclude the differential diagnosis of craniopharyngioma.
We describe a 12-year-old boy addressed for suspicion of craniopharyngioma diagnosed by decreased visual acuity, bitemporal hemianopia and a CT scan showing a large hypodense suprasellar lesion with intralesional calcifications. Despite the unusual localization and size of this lesion, the absence of dermal sinus commonly found, and before visualizing a hyperintense mass on MRI-diffusion, the diagnosis of craniopharyngioma was ruled out in favor of a dermoid cyst. Radical excision was performed.
In the suprasellar area, craniopharyngioma and dermoid cyst may have very similar radiological aspects: low density masses on CT scan and a hyperintense signal on T1-weighted MRI sequences with a variable signal on T2-weighted sequences. Hitherto, only two cases in literature have described suprasellar dermoid cyst. Their initial diagnosis was facilitated by the presence of a dermal sinus.
KeywordsDermoid cyst Suprasellar Craniopharyngioma MRI diagnosis
A.A. and S.P. wrote the manuscript. A.B, R.C, and P.B collected the data and reviewed the manuscript.
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Conflict of interest
The authors declare that they have no personal conflicts of interest and no institutional financial interest in any drugs, materials, or devices described in this manuscript. The authors have no financial disclosures to report. In addition, patient gave informed consent for any medical and scientific investigations. This paper has not been published previously, is not under consideration for publication elsewhere, and that, if accepted, will not be published elsewhere in the same form, in English or in any other language, without the written consent of the publisher.
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