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KMID : 0942820120110010009
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Journal of Korean Brain Tumor Society
2012 Volume.11 No. 1 p.9 ~ p.15
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Posterior Fossa Epidermoid Tumors : Clinical Characteristics and Treatment Outcomes
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Park Jung-Hoon
Kim Eal-Maan
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Abstract
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Objectives: Posterior fossa epidermoid tumors (PFETs) intimately involve cranial nerves and vascular structures, and may be tightly adherent to them and to the brain stem. The present report details the clinical characteristics of PFETs and assess their therapeutic outcomes.
Methods: We reviewed the clinical manifestations, radiographic features, operative findings, and surgical outcomes in 22 patients of PFETs treated surgically for a period of 15 years. The male to female ratio was 3 : 8 and the mean age of the patients was 46 years.
Results: Tumors varied in size from 20 to 59 mm (mean 29.6 mm). The most frequent location was the cerebellopontine angle (15 cases) and other locations included cerebellar vermis (2 cases), medulla (2 cases), petroclivus (2 cases), and 4th ventricle (1 case). Common clinical features were trigeminal neuralgia in 11 cases, cerebellar signs 7 cases, headache 5 cases, facial weakness or spasm 5 cases, and hearing disturbance 4 cases. Total and subtotal resections were achieved in 15 cases (68.2%) and seven cases respectively. The trigeminal neuralgia resolved in the 8 cases (72.7%), as well as the headache in all patients. Complications affected the cranial nerves included diplopia (13.6%), facial palsy (9.1%), dysphagia (4.5%), and facial paresthesia (4.5%). Three cases (13.6%) developed aseptic meningitis postoperatively. At the time of discharge, 15 patients (68.2%) were in excellent condition with complete improvement of the neurological abnormalities.
Conclusion: Microsurgery is the only effective treatment for PFETs, and radical resection of the entire tumor including the capsule, whenever possible, generally results in a good outcome, with minimum recurrence rates.
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KEYWORD
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Cerebellum, Epidermoid, Outcome, Posterior fossa, Trigeminal neuralgia
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