Epidermoid-dermoid cysts may also occur in the pineal region, and are larger and have different signal characteristics on MRI.
The pineal region is a exceptional intracranial epidermoid cyst. Cushing was the first to report the pineal localization of the epidermoid cyst in 1928. Up to now, 85 cases of pineal epidermoid cyst were cited in the literature.
“Trial XRT” should be avoided in tumors suspected of being teratomas or epidermoid cyst on MRI, and the response may be misleading in the relatively common situation of tumors with mixed cell types.
Hassan et al. report a clinical case concerning a 45 years old man who presented an intracranial hypertension during 18 months. The clinical examination found a hemiparesis with a facial hypoesthesis. The MRI showed a process of the pineal region. The patient underwent a surgery with a large resection. The histological examination confirms the epidermoid cyst. Many approaches were described in the literature. The outcome is related to this localization 1).