Recurrent cerebellar abscess secondary to cranial dermal sinus associated with dermoid cyst in children

  • Marcelo Volpon Santos Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
  • Danilo Jorge Pinho Deriggi Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
  • Maria Celia Cervi Division of Pediatric Infectious Diseases, Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
  • Ricardo Santos de Oliveira Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
Keywords: Cerebellar abscess, Dermal sinus tract, Dermoid cyst, Posterior fossa.

Abstract

Background: Posterior fossa dermoid cysts are rare, benign lesions whose diagnosis can be quite challenging because of their slow growth and subsequent paucity of symptoms. We present herein an unusual case of recurrent cerebellar abscesses induced by an adjacent extradural dermoid cyst with a complete occipital dermal sinus.

Methods: The authors report the case of a 20-month-old girl who presented with signs of acutely raised intracranial pressure and whose head scans showed a left cerebellar hemisphere abscess associated with obstructive hydrocephalus. The patient was treated initially with an external ventricular drain, followed by burr-hole aspiration of the abscess and long-term

antibiotics. Since the cerebellar abscess recurred, a posterior fossa craniotomy was performed and gross total resection of the lesion along with the dermal sinus tract and abscess contents was achieved. Histopathological analysis confirmed a dermoid tumor.

Conclusions: The occurrence of recurrent cerebellar abscesses must always rise up the suspicion of an associated dermoid cyst. Neuroradiological scans should be carefully evaluated in search for this lesion. Once the diagnosis is established, radical resection of the cyst, sinus tract and infectious components is the treatment of choice.

   

Author Biographies

Marcelo Volpon Santos, Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Brazil

 

 
Danilo Jorge Pinho Deriggi, Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Brazil

 

 
Maria Celia Cervi, Division of Pediatric Infectious Diseases, Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Brazil

 

   
Ricardo Santos de Oliveira, Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Brazil

 

     

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Published
2019-08-10
Section
Clinical Case Reports