P.160 Convexity dermoid cyst: a case report and review of the literature

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Background: Dermoid cysts are rare benign intracranial lesions arising from abnormal neuroectodermal folding during embryogenesis. While typically midline, near the sella or posterior fossa, we report an unusual case of a convexity dermoid cyst extending into the sylvian fissure. Methods: A 33-year-old female with a left convexity mass underwent resection, confirming a dermoid cyst. A literature review was also conducted. Results: The patient presented with progressive, intermittent right-sided hand and face paresthesias. CT showed a 4.3 × 4.7 cm hypodense lesion with peripheral calcification contiguous with the calvarium. MRI revealed an extra-axial, T2-hyperintense, T1-hypointense lesion with internal septations extending from the calvarium into the sylvian fissure. Craniotomy achieved gross total resection, revealing a soft lesion with interwoven hair, suggestive of a dermoid cyst. Pathology confirmed a cystic lesion with mature squamous epithelium, keratin, skin appendages, and chronic inflammation. Conclusions: Dermoid cysts are rare intracranial lesions that most commonly occur in the midline. This case highlights a rare convexity dermoid cyst, expanding our understanding of its atypical locations.

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