1. Introduction

epidermoid cyst is a slowly growing, rare and benign developmental tumour of an ectodermal origin. It is usually found in the central nervous system, however, it can also appear in other organs, such as the middle ear or the orbit [11].

Epidermoid cysts constitute 0.2–1% of intracranial tumours and are most often (60%) located in the cerebellopontine angle (7% of all tumours in this area) and in the parasellar region. Intraventricular location is unusual.

Epidermoid cysts developing in this region constitute only 5–18.5% of all epidermoid cysts that appear in the brain [3], [10], [12]. And only 82 cases were published in the literature [15].

We report two cases of epidermoid cyst of the fourth ventricle surgically treated in our department in 2020 and discuss the clinico-radiological, therapeutic and evolutionary features of this unusual localization.

2. Case report

2.1. First case

A 52 old male who was admitted to the Neurosurgery Department for cerebellar stato-kinetic syndrom.

The patient suffered from balance disorder evolving for 8 months.

At admission, the clinical examination found a conscious cooperative patient, ataxia with wide base and staggering gait, Dysdiadochokinesia, dysmetria at the finger to nose and finger to finger test, hypotonia, he patellar osteo tendinous reflex was pendular without associated sensory motor deficit cerebral computer tomography showed a cystic and solid hypodense vermal tumor not taking the contrast, dragging the V4 and the brainstem forward Fig. 1.

Keywords

Epidermoid cyst, Fourth ventricle