• Lopez Gomez Patricia P Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain. Electronic address: patricia91lpz@gm, Mato Mañas David D Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain., and Marco de Lucas Enrique E Department of Neurorradiology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain..
• Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain. Electronic address: patricia91lpz@gmail.com.
• World Neurosurg. 2021 Feb 1; 146: 75-77.

AbstractEpidermoid cysts (ECs) are benign extraaxial tumors. They frequently occur at the cerebellopontine angle and parasellar regions. However, they rarely occur in the Meckel's cave. Typically, ECs appear as a hypointense mass on T1-weighted magnetic resonance imaging (MRI) and hyperintense on T2-weighted MRI. However, ECs may occasionally present as hyperintense on T1-weighted imaging and hypointense on T2-weighted imaging. When this occurs, they are known as white epidermoid cysts. We present a case of a 25-year-old woman with a 3-month history of hypoesthesia in the distribution of the right trigeminal nerve. MRI showed a lesion located within the Meckel's cave. The MRI signal was heterogeneous, with hyperintense areas on T1-weighted images, being hypointense on T2-weighted imaging. Preoperative suspicion was trigeminal schwannoma with unusual radiologic features. Finally, the pathologic diagnosis was epidermoid cyst. Therefore to establish a proper preoperative diagnosis, one should be aware that ECs can occur in Meckel's cave and with unusual radiologic features, as occurred in the case described earlier.Copyright © 2020 Elsevier Inc. All rights reserved.

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