Dermoid lesion of the cavernous sinus: case report and review of the literature

Intracranial dermoids are rare congenital tumors. Supratentorial dermoid cysts were more frequently reported in the last decade, and they are known to have a predilection for the cavernous sinus. Interdurally localized dermoids presenting with ophthalmoplegia is uncommon. Previously, the association of dermoid lesions with the cavernous sinus and the complexity of the operative procedure were emphasized only by a few authors. We report a case of a dermoid cyst that was embedded fully in the cavernous sinus and review the related cavernous dermoid lesions in the literature. Fronto-orbitozygomatic craniotomy was performed, and despite adherence of the tough capsule to the cranial nerves, the lesion was grossly removed in total. The patient was doing well 1 year after the operation, and there was no recurrence of signs and symptoms. Interdural growth of cavernous dermoid tumors must be considered, and careful evaluation of preoperative computed tomography and magnetic resonance images aids in making the decision concerning the operative approach. Upon review of the literature, we detected only eight similar cases concerning cavernous dermoid cysts. Although total excision of these cavernous lesions has been reported previously, we believe that total excision can sometimes be hazardous and not feasible.