Extradural dermoid tumours of the posterior fossa
a `Virgen de la Arrixaca' University Hospital;
Department of Neurosurgery, b Department of Pathological Anatomy, c Department of Neuropaediatrics
Correspondence to: and reprint requests to: Dr Juan F Martínez-Lage, Regional Service of Neurosurgery, `Virgen de la Arrixaca' University Hospital, National Health Service, El Palmar, E-30120 Murcia, Spain.
Accepted 2 July 1997
Dermoid tumours in children usually occur in two locations: at
the anterior fontanelle and on the occipital squama. An exceptional site of origin for a posterior fossa dermoid cyst is the extradural space. There are only six previous cases of this situation reported in
the literature. A series of 103 subscalp and calvarial masses in
children were reviewed and three children are reported with extradural
dermoids of the posterior fossa, which communicated with the skin
through midline occipital dermal sinuses. All three children were seen
after the rapid growth or the formation of an abscess in a previously
noted occipital subcutaneous mass present since birth. Although
computed tomography or magnetic resonance imaging showed the dermal
sinus and the intracranial tumour, these studies were unable to
ascertain the intradural or extradural nature of the tumours, their
exact origin only being established at operation. Histopathological
study showed preclinical signs of infection in the two patients that
had not yet formed an abscess. It is suggested that early neurosurgical
treatment of these neoplasms should be done to prevent the development
of severe intracranial infection. The previously reported simplicity of
surgical removal of occipital extradural dermoids was not confirmed in
this series.
© 1997 by Archives of Disease in Childhood
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