Pineal Gland Epidermoid cyst, a rare Tumor

Background: Intracranial epidermoid cysts, forming 1% of adult and 3-8% of pediatric brain tumors, are among the rarest of intracranial neoplasms. Originating from ectodermal remnants retained during embryonic development, pineal epidermoid cysts are rare benign tumors that often manifest as obstructive hydrocephalus due to midbrain tectum compression. Objective: To report on the clinical presentation, diagnostic process, and surgical management of a pineal epidermoid cyst in a young adult, emphasizing the role of ventriculoperitoneal shunting and the outcomes of surgical intervention. Methods: A case study of a 20-year-old male presenting with a 4-month history of occipital headaches and vertigo, without seizures, neurological deficits, or visual disturbances. Diagnostic evaluation included brain imaging that revealed hydrocephalus secondary to a pineal space-occupying lesion. A ventriculoperitoneal shunt was placed for obstructive hydrocephalus treatment prior to the surgical excision of the pineal lesion. Results: The patient underwent a ventriculoperitoneal shunting procedure, followed by a suboccipital transtentorial craniotomy 2 months later, leading to the complete resection of the pineal space-occupying lesion. The histopathological analysis confirmed the diagnosis of a pineal epidermoid cyst. Post-surgical follow-up indicated significant symptomatic improvement with no recurrence observed. Conclusion: Pineal epidermoid cysts, while rare, can significantly impact patient well-being through the development of obstructive hydrocephalus. Early intervention with ventriculoperitoneal shunting followed by surgical resection can lead to favorable outcomes. Long-term monitoring is essential to ensure there is no recurrence.