open access

Vol 50, No 2 (2016)
Original research articles
Submitted: 2015-08-03
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Epidermoid cysts of the cerebellopontine angle: Clinical features and treatment outcomes

Tomasz Czernicki, Przemysław Kunert, Arkadiusz Nowak, Jakub Wojciechowski, Andrzej Marchel
DOI: 10.1016/j.pjnns.2015.11.008
·
Neurol Neurochir Pol 2016;50(2):75-82.

open access

Vol 50, No 2 (2016)
Original research articles
Submitted: 2015-08-03

Abstract

Objective

To report clinical characteristics, treatment outcomes and risk of recurrence in patients with surgically treated cerebellopontine angle epidermoids.

Methods

In 1994–2013, we operated 17 patients, including 7 with tumor limited to the cerebellopontine angle, 7 with cerebellopontine angle tumor penetrating supratentorially, and 3 with cerebellopontine angle tumor extending along skull base to contralateral cerebellopontine angle. All patients were followed-up for the mean duration of 126 months.

Results

On admission cranial nerve symptoms predominated. Total tumor removal was achieved in 5 patients, and incomplete removal (with small tumor remnants left on vessels, nerves, or brainstem) in 12 patients. Postoperatively, preoperative deficits worsened in 2 and new postoperative deficits occurred in 10 patients. The extent of tumor expansion had no effect on postoperative morbidity and risk of recurrence. During long-term follow-up, improvement or resolution of preoperative deficits was seen in 11 of 17 patients, and new postoperative deficits in 8 of 10 patients. Symptomatic recurrences after an average of more than 9 years were noted in 5 patients, 3 of whom were reoperated. Recurrences occurred in some younger patients and always in area of primary tumor. No effect of extent of tumor removal on risk of recurrence was found.

Conclusions

The extent of tumor removal had no effect on the risk of recurrence, and thus it may be acceptable to leave tumor capsule fragments adhering closely to nerves, vessels, or brainstem. During long-term follow-up, resolution or improvement of present preoperatively and new postoperative neurological deficits may be expected in most patients.

Abstract

Objective

To report clinical characteristics, treatment outcomes and risk of recurrence in patients with surgically treated cerebellopontine angle epidermoids.

Methods

In 1994–2013, we operated 17 patients, including 7 with tumor limited to the cerebellopontine angle, 7 with cerebellopontine angle tumor penetrating supratentorially, and 3 with cerebellopontine angle tumor extending along skull base to contralateral cerebellopontine angle. All patients were followed-up for the mean duration of 126 months.

Results

On admission cranial nerve symptoms predominated. Total tumor removal was achieved in 5 patients, and incomplete removal (with small tumor remnants left on vessels, nerves, or brainstem) in 12 patients. Postoperatively, preoperative deficits worsened in 2 and new postoperative deficits occurred in 10 patients. The extent of tumor expansion had no effect on postoperative morbidity and risk of recurrence. During long-term follow-up, improvement or resolution of preoperative deficits was seen in 11 of 17 patients, and new postoperative deficits in 8 of 10 patients. Symptomatic recurrences after an average of more than 9 years were noted in 5 patients, 3 of whom were reoperated. Recurrences occurred in some younger patients and always in area of primary tumor. No effect of extent of tumor removal on risk of recurrence was found.

Conclusions

The extent of tumor removal had no effect on the risk of recurrence, and thus it may be acceptable to leave tumor capsule fragments adhering closely to nerves, vessels, or brainstem. During long-term follow-up, resolution or improvement of present preoperatively and new postoperative neurological deficits may be expected in most patients.

Get Citation

Keywords

Epidermoid cyst, Cerebellopontine angle, Surgery, Treatment outcome, Cranial nerve deficits

About this article
Title

Epidermoid cysts of the cerebellopontine angle: Clinical features and treatment outcomes

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 50, No 2 (2016)

Pages

75-82

DOI

10.1016/j.pjnns.2015.11.008

Bibliographic record

Neurol Neurochir Pol 2016;50(2):75-82.

Keywords

Epidermoid cyst
Cerebellopontine angle
Surgery
Treatment outcome
Cranial nerve deficits

Authors

Tomasz Czernicki
Przemysław Kunert
Arkadiusz Nowak
Jakub Wojciechowski
Andrzej Marchel

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