Occipital Dermoid Cysts

Figure epid_8a_n.jpg and epid_8b_n.jpg: Occipital epidermoid and dermoid cyst. Figure epid_8a_n.jpg: 8-month-old infant with an occipital mass. Operatively and histologically an epidermoid cyst of category 1. Especially in occipital and frontal midline localization, an intracranial extension must be excluded without a doubt prior to surgery. Figure epid_8b_n.jpg: Occipital dermoid cyst of the category 5b. The drawing of the sagittal cross-section of the occipital region illustrates such a case. The subcutaneous cystic part in the midline beyond the posterior fontanel runs into a track which penetrates the occipital bone and the dura, continues between the cerebellar hemispheres and ends in a cystic part which is larger than the palpable subcutaneous part at the occiput. The case illustrates the necessity of a neuroradiological work-up in midline masses of the head; without exclusion of an intracranial connection, an excision should not be performed under out-patient conditions.