Huge epidermoid cyst ( video )

Intracranial epidermoid cysts are relatively common congenital lesions which account for about 1% of all intracranial tumours. They result from inclusion of ectodermal elements during neural tube closure, and typically present in middle age due to mass effect on adjacent structures. Their content, derived from desquamated epithelial cells, mimics CSF on CT and MRI, with the exception of DWI which demonstrates restricted diffusion. Management is surgical and prognosis is good.

Although predominantly congenital, epidermoid cysts are usually very slow growing and as such take many years to present. Typically patients are between 20 and 40 years of age 6. There may be increased prevalence in males, although this is not found in all series 5-6.
Epidermoid cysts account for approximately 1% of all intracranial tumours 2,8.
An uncommon association exists with anorectal anomalies, sacral anomalies and presacral mass, and is known as the Currarino triad