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Brain Tumor, Epidermoid

Brain Tumor, Epidermoid is a topic covered in the 5-Minute Clinical Consult.

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  • Epidermoid tumors are benign, congenital cysts that occur intradurally and extradurally. They are slow-growing and produce symptoms gradually.
  • Also called epidermoid cysts, primary cholesteatomas, and epidermoid inclusion cysts
  • Third most common tumors of the cerebellopontine angle (CPA)



Rare intracranial growths constituting 1.8–2.2% of all intracranial tumors

  • Presentation can be at any age but most commonly between the 3rd and 5th decades of life.
  • Equal incidence in men and women
  • There is a wide ethnic distribution, and there is no known preponderance in any region.

Etiology and Pathophysiology

  • Considered a benign lesion; malignant transformation is rare.
  • Growth is secondary to accumulation of desquamated epithelial cells; follows a linear growth rate
  • Symptoms are due to mass effect and displacement of local structures. Depending on tumor location, it may result in cranial nerve, blood vessel, and brainstem compression.
  • Derived from squamous epithelium that is included during neural tube closure
  • Epidermoid tumors grow slowly from the buildup of keratin and cholesterol from the continual shedding of the epithelium lining the cyst.
  • Formed at the time of neural tube closure between the 3rd and 5th weeks of embryonic life
  • Common locations include CPA, parapontine, parapituitary, middle cranial fossa, and dipole of the fontanel.
  • Multiple lumbar punctures have been known to be a rare cause.

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Stephens, Mark B., et al., editors. "Brain Tumor, Epidermoid." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816359/all/Brain_Tumor__Epidermoid.
Brain Tumor, Epidermoid. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816359/all/Brain_Tumor__Epidermoid. Accessed April 20, 2019.
Brain Tumor, Epidermoid. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816359/all/Brain_Tumor__Epidermoid
Brain Tumor, Epidermoid [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 20]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816359/all/Brain_Tumor__Epidermoid.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Brain Tumor, Epidermoid ID - 816359 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816359/all/Brain_Tumor__Epidermoid PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -