====== Sylvian fissure epidermoid cyst ======

[[Epidermoid cyst]]s within the [[Sylvian fissure]] are extremely rare. [[Expressive aphasia]], and [[cognitive disorder]] because of mass effect have never been reported previously.

Zenonos et al. from the Department of Neurosurgery, University of [[Pittsburgh]] Medical Center, USA, discuss the case of a 53 year old male who presented with an acute episode of expressive aphasia and vision changes along with progressive [[headache]]s and [[cognitive decline]] over the past 2.5 years. A detailed neurological examination revealed subtle [[conduction aphasia]], as well as mild short-term [[memory impairment]]. Magnetic resonance imaging revealed a cystic mass consistent with epidermoid cyst within the left Sylvian fissure. High Definition Fiber-[[Tractography]] showed that the [[arcuate fasciculus]] was stretched by the tumor. A left [[frontotemporal craniotomy]] allowed for near-total excision of the [[cyst]] and led to rapid and complete resolution of symptoms.

Although rare, epidermoid cysts of the dominant sylvian fissure can present with progressive aphasia due to mass effect on the arcuate fasciculus. Despite the long-standing symptoms, surgical resection can lead to their complete resolution
((Zenonos GA, Fernandes Cabral DT, Olexa J, Friedlander RM. Left Sylvian Fissure
Epidermoid Cyst Presenting with Progressive Aphasia. World Neurosurg. 2018 Aug
30. pii: S1878-8750(18)31947-8. doi: 10.1016/j.wneu.2018.08.164. [Epub ahead of
print] PubMed PMID: 30172982.
)).
----
A 27-year-old female with a large epidermoid cyst located in the right Sylvian fissure who presented with a headache, hearing impairment and tinnitus. She underwent craniotomy and complete resection of the tumor with the resolution of the tinnitus. Such location and presentation are rarely encountered for epidermoid tumors
((http://www.neurores.org/index.php/neurores/article/view/426/422)).
----

Shah et al. report the case of a 24-year-old male with a large sylvian fissure epidermoid tumor who presented with intention tremor. The patient was operated, and a near-total excision of the tumor was performed with a resolution of the tremor
((Shah A, Makkiyah F, Goel A. Sylvian fissure epidermoid cyst presenting with
intention tremor. Asian J Neurosurg. 2016 Apr-Jun;11(2):174-5. doi:
10.4103/1793-5482.175620. PubMed PMID: 27057232; PubMed Central PMCID:
PMC4802947.)).
----
A patient with unruptured dermoid cyst in the left sylvian fissure who was operated successfully without any residual deficit
((Anand D, Aggarwal S, Soin D, Garg R. Sylvian Fissure Dermoid Cyst - A Rare
case. J Clin Diagn Res. 2014 Sep;8(9):RD01-2. doi: 10.7860/JCDR/2014/8917.4789.
Epub 2014 Sep 20. PubMed PMID: 25386502; PubMed Central PMCID: PMC4225954.
)).

===== References =====