Surgical outcome of posterior fossa epidermoid tumors [1980-2008]

ABSTRACT

Epidermoid tumors comprise 5% of posterior fossa tumors and are the third among tumors of the cerebellopontine region in frequency. In the review of recent literature, there are several case reports but few case series. In this retrospective study, we evaluated the surgical results of our patients, reviewed the existing literature and compared our results with other series. Surgical results of 8 patients with epidermoid tumor that originated mostly in the posterior fossa from 1980-2008 in Mehrad Hospital, in Tehran, are presented. The age, sex, duration, signs and symptoms, topographical location, surgical approach, the extent of resection and outcome are analyzed and compared with other series. This study is based on the clinical data of 8 patients operated from 1980-2008 in Mehrad Hospital, in Tehran, due to posterior fossa epidermoid tumors. 62.5% of the patients were female. The average age of our patients were 34.1 years [range 2453 years]. The most common symptom was headache [87.5%]. The most common tumor location was cerebellopontine angle. Supratentorial extension was observed in half of our patients. In 37.5% of the cases, the tumor was resected totally. The mean followup period was 31.5 months [range 1-115 months]. In the post operative period, 37.5% of our patients suffered from complicating events, but we had no mortality in our series. In contrast with other posterior fossa benign tumors, in which the cure is obtained by overcoming surgical technical difficulties, the main problems in the management of epidermoids remain misdiagnosis, incomplete removal at the first operation, and delayed detection of recurrences. With the use of modern microneurosurgical techniques, our surgical results are comparable with other series. Extended multicentric prospective studies are recommended for more definitive results: