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Neurology India
Medknow Publications on behalf of the Neurological Society of India
ISSN: 0028-3886 EISSN: 1998-4022
Vol. 56, Num. 2, 2008, pp. 209-210

Neurology India, Vol. 56, No. 2, April-June, 2008, pp. 209-210

Letter To Editor

Third ventricular dermoid: An unusual tumor at an unusual site

Iyer VeenaR, Sanghvi DarshanaA

Department of Radiology, Seth GS Medical College and KEM Hospital, Parel - 400 012, Mumbai, Maharashtra
Correspondence Address:Department of Radiology, Seth GS Medical College and KEM Hospital, Parel - 400 012, Mumbai, Maharashtra

Code Number: ni08059

A dermoid is an inclusion cyst having ectodermal elements. Dermoids have an outer connective tissue capsule and are lined with stratified squamous epithelium. The cyst contents include hair follicles, sebaceous glands and sweat glands. Desquamated epithelium and some lipid material are found in the center. Intracranial dermoids account for about 0.04 to 0.6% of all intracranial neoplasms. [1] They commonly occur in the cranial midline, in the posterior fossa, the suprasellar cisterns and the sub-frontal areas. Intraventricular dermoids are rare and occur most frequently in the fourth ventricle. The occurrence of a dermoid in the third ventricle is extremely rare. [2],[3] We present the case of a nine-year-old female with a dermoid in the third ventricle.

The patient presented with complaints of severe headache and fever for a year. The symptoms worsened over a period of two months when the patient developed an ataxic gait, decreased hearing in the left ear and blurred vision. There was no history of loss of consciousness, convulsions, diplopia or facial asymmetry. A computed tomography (CT) scan and magnetic resonance imaging (MRI) of the brain was performed, which showed an unusually striking image of a dermoid in the third ventricle with islands of fat, calcification and an abundance of hair [Figure - 1],[Figure - 2].

Islands of fat were seen within the lesion, showing negative Hounsfield Units on CT images [Figure - 1] and appearing hyperintense on T1-weighted images [Figure - 2]. Focal calcifications were observed in the lesion as hyperdense foci on CT and areas of susceptibility on gradient MRI. Thin linear structures radiated dramatically from the center of the lesion which represented hair giving the lesion a ′sun and rays′ pattern [Figure - 2],[Figure - 3],[Figure - 4].

References

1.Osborn AG. Miscellaneous tumors, cysts and metastasis. In Diagnostic Neuroradiology. Elsevier; Imprint Mosby: 1993. p. 635.  Back to cited text no. 1    
2.Caldarelli M, Massimi L, Kondageski C, Di Rocco C. Intracranial midline dermoid and epidermoid cysts in children. J Neurosurg 2004;100:473-80.  Back to cited text no. 2  [PUBMED]  
3.Aoki H, Abiko S. Dermoid cyst of the third ventricle in child. No Shinkei Geka 1978;6:1049-53.  Back to cited text no. 3  [PUBMED]  

Copyright 2008 - Neurology India


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[ni08059f2.jpg] [ni08059f1.jpg] [ni08059f4.jpg] [ni08059f3.jpg]
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