A RARE CASE REPORT OF PINEAL EPIDERMOID CYST PRESENTING WITH SYMPTOMS OF HYDROCEPHALUS

Epidermoid cysts may be congenital (most common, arising from ectodermal inclusion during neural tube closure 8) or acquired (post-surgical or post-traumatic implantation). Pathologically, intracranial epidermoid cysts are identical to the petrous apex and middle ear congenital cholesteatomas. They differ from dermoid cysts which have both epidermal and skin appendages such as hair and sebaceous cysts and mature teratomas which have all three layers. They have a thin capsule which is made of a thin layer of squamous epithelium, which macroscopically is white and pearly, and may be smooth, lobulated, or nodular. Internal cystic components are often filled with desquamated epithelial keratin and cholesterol crystals; grossly appearing as a creamy, waxy material. Cholesterol and keratin components account for their distinct imaging characteristics 2.