Investig Magn Reson Imaging.  2018 Sep;22(3):172-176. 10.13104/imri.2018.22.3.172.

Coexistence of Intracranial Squamous Cell Carcinoma and Epidermoid Cyst: a Case with Consecutive Imaging Findings

• Lee CW
• Park JE
• Lee JH
• Kim HS
• Kim SJ

• KMID: 2421549
• DOI: http://doi.org/10.13104/imri.2018.22.3.172

Abstract

In contrast to well-known imaging findings of intracranial epidermoid cysts on magnetic resonance imaging, those of intracranial squamous cell carcinoma (SqCC) are relatively unknown. We present a case of coexistence of intracranial SqCC and epidermoid cyst, with consecutive follow up over 14 months. Based on our case, a solid enhancing portion adjacent to a typically-looking epidermoid cyst may become a clue for coexistence of intracranial SqCC. An initial contrast enhancement and/or heterogeneous signal on diffusion weighted imaging may become a useful diagnostic clue, but more importantly, sudden rapid growth is important in formulating diagnosis.

Keyword

squamous cell carcinoma; epidermoid cyst; magnetic resonance imaging

MeSH Terms

Carcinoma, Squamous Cell*
Diagnosis
Diffusion
Epidermal Cyst*
Epithelial Cells*
Follow-Up Studies
Magnetic Resonance Imaging

Figure

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  Fig. 1 Initial MRIs were taken at a local hospital, which show lobulated lesion in the basal cistern on (a) FLAIR image, and (b) contrast-enhanced T1WI shows no definite enhancing portion in the lesion. (c) DWI and (d) ADC images show diffusion restriction of the lesion (arrows). Another 1.3 cm sized enhancing lesion was noted in the right CP angle on (e) contrast-enhanced T1WI. Mild but heterogeneous diffusion restriction is shown on (f) DWI and (g) ADC (arrowheads). ADC = apparent diffusion coefficient; DWI = diffusion-weighted image; FLAIR = fluid-attenuated inversion recovery; MRI = magnetic resonance imaging; T1WI = T1-weighted image

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  Fig. 2 Ophthalmologic examination and clinical photo show severe corneal ulceration on the right side, which was getting worse despite proper management.

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  Fig. 3 Second MRIs were taken 5 months after the initial MRIs. The high signal intensity lesion on (a) FLAIR image is more prominent since the previous examination, and the enhancing lesion on (b) T1WI has increased in size as well, with minimal enhancement on (c) contrast-enhanced FLAIR image.

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  Fig. 4 Third MRIs were taken 9 months after the second MRIs or 14 months after the initial MRIs. The extent of high signal intensity lesion on (a) FLAIR image has been increased, and the size of enhancing lesion on (b) T1WI increased further, with minimal enhancement on (c) contrast-enhanced FLAIR image.

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