Epidermoid cysts are an unusual form of brain tumour. Strictly speaking, they are not a tumour but rather an abnormality brought about by what is effectively the inclusion of skin cells during brain formation. Whilst the condition effectively arises whilst being formed in the womb, it is not in any way an inheritable or genetic condition. They skin cells are not in themselves a problem but in rare cases during early adult life or middle age, can cause problems by producing the normal lining of the skin, keratin. This material produces an intracranial epidermoid cyst because, it produced by these abhorrent skin cells, cannot disperse the amount of keratin and, therefore, the size of the cyst is a function of the amount of skin cells and they means that they can present at any age from 20 to 60.
The presenting features are varied and can be due to the irritant nature of the keratin or to the size of the cyst and pressure on the brain. The features with which the cyst can present include facial weakness or hemifacial spasm, trigeminal neuralgia and unsteadiness. Occasionally, they are picked up as an incidental finding on an MR scan done for other reasons. Should they require treatment, this is invariably surgical with the surgery aimed at removal of the abnormal tissue. Like other conditions dealt with by the Brain and Spine Clinic, the surgical results are dependent on the experience and expertise of your surgeon. Details of the surgery are described in the treatment section.
The management of your epidermoid cyst will not only be discussed between you and your surgeon, but also at a Skull Base Multidisciplinary Team (MDT) Meeting. These are held fortnightly at Salford Royal Hospital, with a team of experts with a huge combined experience of managing such problems. Your surgeon will convey the outcome and recommendations of this meeting to you. Whilst this will provide you with all the information you require about your epidermoid cyst, as well as a detailed analysis of the advantages and disadvantages of all management options, the most important factor in the final decision is you. Your personal opinion of what is best for you is undoubtedly the most relevant aspect of how you will be managed.