EC Neurology

Introduction: Intracranial epidermoid cysts, also known as cholesteatomas or benign epithelial cysts, represent an uncommon subset of congenital lesions, marked by their slow-growing and non-malignant characteristics. These cysts are most commonly located in the cerebello-pontine angle cistern, which corresponds to their typical site of presentation. However, the appearance of such cysts within the intra-clival region, particularly along the midline, is exceedingly rare and deviates from the usual anatomical locations.
Case Report: We report a rare case of an intra-clival epidermoid cyst in a young woman in her third decade of life. The cyst’s unusual localization within the clivus-a deep and less readily accessible region-highlights the unique nature and diagnostic challenge of this presentation. This case underlines the uncommon nature of epidermoid cysts and stresses the importance of maintaining a wide differential diagnosis for lesions in atypical anatomical sites.
Conclusion: This case holds significance not only due to its rarity but also because of its implications for clinical practice and diagnostic imaging. The intra-clival location of the cyst demonstrates that cholesteatomas may present in unexpected areas, expanding the differential diagnosis spectrum. Given the complexity of evaluating deep-seated regions, advanced imaging modalities, particularly magnetic resonance imaging (MRI), are essential for accurate identification and characterization of such lesions. This case emphasizes the critical role of comprehensive imaging in the diagnostic process and contributes to a broader understanding of the diverse manifestations of epidermoid cysts.

Keywords: Medicine; Clivus; Cholesteatoma; Epidermoid Cyst; MRI

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