An Unusual Cavernous Sinus Epidermoid Tumor with Intradural Dissemination: A Case Report

Introduction: Epidermoid tumors are benign slow-growing tumors that can be found in several locations in the brain or spinal cord, mainly within the cerebellopontine and suprasellar cisterns, rarely giving neurological complications. The occurrence of multiple intracranial epidermoid cysts or ruptured epidermoid cysts with intrathecal seeding is very rare. Furthermore, multiple fat-intensity lesions can be a challenge in the neuroradiological diagnosis. Methods: We reviewed the cases of nonmeningiomatous tumors of the cavernous sinus and the epidermoid tumors operated in our hospital in the last 8 years and their neurological symptoms. Results: We describe a case of a 51-year-old female with longstanding recurrent headaches and mild numbness over her left cheek. Her imaging studies showed an epidermoid tumor in the left cavernous sinus and multiple fat-intensity lesions in the subarachnoid space. Radical removal of the epidermoid tumor was obtained through a cranio-orbitozygomatic approach with an extradural exposure of the cavernous sinus without any postop additional morbidity. Conclusions: We have documented the CT and MR imaging appearance and the operative findings of a very rare case of epidermoid tumor of the cavernous sinus with intrathecal dissemination of epidermoid cyst.