Child's Nervous System

, Volume 34, Issue 2, pp 359–362 | Cite as

Child dermoid cyst mimicking a craniopharyngioma: the benefit of MRI T2-weighted diffusion sequence

  • Aymeric AmelotEmail author
  • Alin Borha
  • Raphael Calmon
  • Patrick Barbet
  • Stephanie Puget
Case Report



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.

Case report

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.


Dermoid cyst Suprasellar Craniopharyngioma MRI diagnosis 


Author contributions

A.A. and S.P. wrote the manuscript. A.B, R.C, and P.B collected the data and reviewed the manuscript.

Compliance with ethical standards

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has not been published previously, is not under consideration for publication elsewhere, and that, if accepted, will not be published elsewhere in the same form, in English or in any other language, without the written consent of the publisher.


  1. 1.
    Aksoy FG, Aksoy OG, Gomori JM (2001) Klippel-Feil syndrome in association with posterior fossa suboccipital dermoid cyst. Eur Radiol 11:142–144CrossRefGoogle Scholar
  2. 2.
    Caldarelli M, Massimi L, Kondageski C, Di Rocco C (2004) Intracranial midline dermoid and epidermoid cysts in children. J Neurosurg Spine 100:473–480Google Scholar
  3. 3.
    Ecker RD, Atkinson JL, Nichols DA (2003) Delayed ischaemic deficit after resection of a large intracranial dermoid: case report and review of the literature. Neurosurgery 52:706–710CrossRefGoogle Scholar
  4. 4.
    Lunardi P, Missori P (1991) Supratentorial dermoid cysts. J neurosurg 75:262–266CrossRefGoogle Scholar
  5. 5.
    Lunardi P, Missori P, Rizzo A, Gagliardi FM (1991) Chemical meningitis in ruptured intracranial dermoid. Case report and review of the literature. Surg Neurol 32:449–452CrossRefGoogle Scholar
  6. 6.
    McLone DG (1997) Images in pediatric neurosurgery. Intracranial dermal sinus and dermoid. Pediatr Neurosurg 27(5):276CrossRefGoogle Scholar
  7. 7.
    Müller HL (2014) Childhood craniopharyngioma: treatment strategies and outcomes. Expert Rev Neurother 14(2):187–197. CrossRefPubMedGoogle Scholar
  8. 8.
    Nagele T, Klose U, Grodd W, Opitz H, Schick F, Steinbrecher A, Voigt K (1996) Three dimensional chemical shift selective MRI of a ruptured intracranial dermoid cyst. Neuroradiology 38:572–574CrossRefGoogle Scholar
  9. 9.
    Phillips WE, Martinez CR, Cahill DW (1994) Ruptured intracranial dermoid tumor secondary to closed head trauma. Computed tomography and magnetic resonance imaging. J Neuroimaging 4:169–170CrossRefGoogle Scholar
  10. 10.
    Rubin G, Scienza R, Pasqualin A, Rosta L, Da Pian R (1989) Craniocerebral epidermoids and dermoids. A review of 44 cases. Acta Neurochir 97:1–16CrossRefGoogle Scholar
  11. 11.
    Schneider UC, Koch A, Stenzel W, Thomale UW (2012) Intracranial, supratentorial dermoid cysts in paediatric patients—two cases and a review of the literature. Childs Nerv Syst 28(2):185–190CrossRefGoogle Scholar
  12. 12.
    Smith AS, Benson JE, Blaser SI, Mizushima A, Tarr RW, Bellon EM (1991) Diagnosis of ruptured intracranial dermoid cyst: value MR over CT. Am J Neuroradiol 12:175–180PubMedGoogle Scholar
  13. 13.
    Stephenson TF, Spitzer RM (1987) MR and CT appearance of ruptured intracranial dermoid tumors. Comput Radiol 11:249–251CrossRefGoogle Scholar
  14. 14.
    Takeuchi H, Kubota T, Kabuto M, Izaki K (1993) Ruptured suprasellar dermoid cyst presenting olfactory delusion (Eigengeruchs erlebnis). Neurosurgery 33:97–99PubMedGoogle Scholar
  15. 15.
    Yasargil MG, Abernathey CD, Sarioglu AC (1989) Microsurgical treatment of intracranial dermoid and epidermoid tumors. Neurosurgery 24:561–567CrossRefGoogle Scholar
  16. 16.
    Yoshimoto K, Nishio S, Suzuki S, Fukui M, Hasuo K (1997) Movable oil in the brain: intracranial ruptured dermoid tumors. J Neurosurg 86(4):734CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Pediatric NeurosurgeryNecker Hospital, Université René Descartes, Paris Cité SorbonneParisFrance
  2. 2.Department of NeurosurgeryCaen HospitalCaenFrance
  3. 3.Department of Pediatric NeuroradiologyNecker Hospital, Université René Descartes, Paris Cité SorbonneParisFrance
  4. 4.Department of PathologyNecker Hospital, Université René Descartes, Paris Cité SorbonneParisFrance

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