Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2021; 9(16): 4046-4051
Published online Jun 6, 2021. doi: 10.12998/wjcc.v9.i16.4046
Asymptomatic traumatic rupture of an intracranial dermoid cyst: A case report
Mei-Hua Zhang, Qi Feng, Han-Lin Zhu, Heng Lu, Zhong-Xiang Ding, Bo Feng
Mei-Hua Zhang, Han-Lin Zhu, Heng Lu, Bo Feng, Department of Radiology, Hangzhou Ninth People's Hospital, Hangzhou 310006, Zhejiang Province, China
Qi Feng, Zhong-Xiang Ding, Department of Radiology, The Affiliation Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Author contributions: Zhang MH, Ding ZX, and Feng B carried out the studies, participated in collecting the data, and drafted the manuscript; Zhang MH, Feng Q, Zhu HL, and Lu H analyzed the imaging data and participated in study design; Feng Q helped to draft the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo Feng, MBBS, Doctor, Department of Radiology, Hangzhou Ninth People's Hospital, No. 98 Yilong Road, Yipeng Street, Xiaoshan District, Hangzhou 310006, Zhejiang Province, China. 9494089@qq.com
Received: January 14, 2021
Peer-review started: January 14, 2021
First decision: February 11, 2021
Revised: February 24, 2021
Accepted: March 24, 2021
Article in press: March 24, 2021
Published online: June 6, 2021
Processing time: 120 Days and 5.4 Hours
Abstract
BACKGROUND

Previous studies reported that most of the intracranial dermoid cyst ruptures were spontaneous, and only a few were traumatic, with asymptomatic much rarer than the symptomatic ruptures. Hence, how to deal with the asymptomatic traumatic rupture of intracranial dermoid cyst remains a challenge in the clinic.

CASE SUMMARY

A 59-year-old man was accidentally diagnosed with intracranial dermoid cyst through a cranial computed tomography (CT) scan due to a car accident. A mixed-density lesion with fat and a calcified margin was observed in the midline of the posterior fossa, accompanied with lipid droplet drifts in brain sulci, fissures, cisterns, and ventricles. After 1 wk of conservative observation, no change was observed on the updated cranial CT scan. After 2 wk of conservative observation, magnetic resonance imaging examination confirmed that the lesion was a traumatic rupture of a posterior fossa dermoid cyst with lipid droplet drifts. As the patient exhibited no adverse symptoms throughout the 2 wk, a 6-mo follow-up visit was arranged for him instead of aggressive treatment. Nonetheless, the patient did not show any abnormal neurological symptoms in the 6 mo of follow-up visits.

CONCLUSION

Asymptomatic traumatic rupture of intracranial dermoid cyst could be just followed or treated conservatively rather than treated aggressively.

Keywords: Intracranial dermoid cyst; Magnetic resonance imaging; Computed tomography; Rupture; Traumatic; Case report

Core Tip: A case of traumatic intracranial dermoid cyst rupture in a 59-year-old man was analyzed retrospectively. Imaging findings, clinical manifestations, treatment, and follow-up results for 6 mo were collected. Combined with the relevant literature, the cause and treatment of asymptomatic cyst rupture were analyzed. For a traumatic intracranial dermoid cyst rupture, if the lesion is small, affects the adjacent structures only slightly, and has few lipid droplet drifts, conservative treatment or only follow-up visits could be adopted according to the patient’s neurological examination results.