Abstract
Intracranial endodermal cysts presenting with hemifacial spasm (HFS) are extremely rare. We report a right cerebellopontine angle (CPA) endodermal cyst in a 56-year-old man who presented with a 6-month history of right-sided hemifacial spasm. Computed tomography revealed a homogenous, well-demarcated, hyperdense lesion extending from prepontine cistern to right CPA. Magnetic resonance imaging demonstrated a right CPA extra-axial cystic lesion protruding into Meckel’s cave, with compression of cranial nerves VII and VIII. Light brown, creamy cystic content was totally removed, and the thin cyst wall surrounding cranial nerves VII and VIII and the right vertebral artery was subtotally removed through the right lateral suboccipital approach. On microscopic examination, the cyst wall was composed of mono- to multilayered stratified epithelia, which were lined by ciliated or nonciliated cuboidal cells, with cilia showing the characteristic 9 + 2 pattern. Immunohistochemistry showed positive staining of cells composing the cyst wall with carcinoembryonic antigen, epithelial membrane antigen, cytokeratin 8, and negative staining with cytokeratin 20, and S-100, thereby characterizing endodermal cyst. Postoperatively, the patient was free of facial spasm.
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References
Jannetta PJ, Abbasy M, Maroon JC et al (1977) Etiology and definitive microsurgical treatment of hemifacial spasm. Operative techniques and results in 47 patients. J Neurosurg 47:321–328
Auger RG, Piepgras DG (1989) Hemifacial spasm associated with epidermoid tumors of the cerebellopontine angle. Neurology 39:577–580
Iwasaki K, Kondo A, Otsuka S et al (1992) Painful tic convulsive caused by a brain tumor: case report and review of the literature. Neurosurgery 30:916–919
Higashi S, Yamashita J, Yamamoto Y et al (1992) Hemifacial spasm associated with a cerebellopontine angle arachnoid cyst in a young adult. Surg Neurol 37:289–292
Prothmann S, Trampel R, Fritzsch D et al (2010) Intracranial neurenteric cysts—rare incidental findings with typical MR signal characteristics. Eur J Radiol (Extra) 74:e41–e45
Harada A, Takeuchi S, Inenaga C et al (2002) Hemifacial spasm associated with an ependymal cyst in the cerebellopontine angle. J Neurosurg 97:482–485
Umezu H, Aiba T, Unakami M (1991) Enterogenous cyst of the cerebellopontine angle cistern: case report. Neurosurgery 28:462–466
Hotta J, Kubokura T, Ozawa H et al (1996) Cerebellopontine angle epithelial cyst presenting as hemifacial spasm. No To Shinkei 48:281–285 (Jpn)
Nagata S, Matsushima T, Fujii K et al (1992) Hemifacial spasm due to tumor, aneurysm, or arteriovenous malformation. Surg Neurol 38:204–209
Lee SH, Rhee BR, Choi SK et al (2010) Cerebellopontine angle tumours causing hemifacial spasm: types, incidence, and mechanism in nine reported cases and literature review. Acta Neurochir 152:1901–1908
Cook BR, Jannetta PJ (1984) Tic convulsif: results in 11 cases treated with microvascular decompression of the fifth and seventh cranial nerves. J Neurosurg 61:949–951
Harris CP, Dias MS, Brockmeier DL et al (1991) Neurenteric cyst of the posterior fossa: recognition, management and embryogenesis. Neurosurgery 29:893–897
Bejjani GK, Wright DC, Schessel D et al (1998) Endodermal cyst of the posterior fossa: report of three cases and review of the literature. J Neurosurg 89:326–335
Tan GS, Hortobágyi T et al (2004) Intracranial laterally based supratentorial neurenteric cyst. Br J Radiol 77:963–965
Preece MT, Osborn AG, Chin SS et al (2006) Intracranial neurenteric cysts: imaging and pathology spectrum. AJNR Am J Neuroradiol 27:1211–1216
Perrini P, Rutherford SA, King AT et al (2008) Enterogenous cysts of the cerebellopontine angle: short review illustrated by two new patients. Acta Neurochir (Wien) 150:177–184
Elmadbouh H, Halpin SF, Neal J et al (1999) Posterior fossa epithelial cyst: case report and review of the literature. AJNR Am J Neuroradiol 20:681–685
Shin JH, Byun BJ, Kim DW et al (2002) Neurenteric cyst in the cerebellopontine angle with xanthogranulomatous changes: serial MR findings with pathologic correlation. AJNR Am J Neuroradiol 23:663–665
Shakudo M, Inoue Y, Ohata K et al (2001) Neurenteric cyst with alteration of signal intensity on follow-up MR images. AJNR Am J Neuroradiol 22:496–498
Orakcioglu B, Halatsch ME, Fortunati M et al (2008) Intracranial dermoid cysts: variation of radiological and clinical features. Acta Neurochir (Wien) 150:1227–1234
Fuse T, Yamada K, Kamiya K et al (1998) Neurenteic cyst at the craniovertebral junction: report of two cases. Surg Neurol 50:431–436
Ellison DW, Perry A, Rosenblum M et al (2008) Tumours: non-neuroepithelial tumours and secondary effects. In: Love S, Louis DN, Ellison DW (eds) Greenfield’s neuropathology, 8th edn. Hodder Arnold, London, pp 2060–2061
Acknowledgment
Some of the figures used here appeared in a short case illustration in Japanese, posted in a regional medical association’s internal bulletin (Kagoishima-ken Ishikaihou) in Japan.
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Karki, P., Bohara, M., Yonezawa, H. et al. Cerebellopontine angle endodermal cyst presenting with hemifacial spasm. Brain Tumor Pathol 28, 371–374 (2011). https://doi.org/10.1007/s10014-011-0042-4
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DOI: https://doi.org/10.1007/s10014-011-0042-4