Epidermoid cyst and abscess following titanium mesh cranioplasty: A rare case report

Background: The development of a slowly enlarging epidermoid cyst (EC) near a scalp incision following titanium mesh cranioplasty (TMC), with subsequent progression to an epidural abscess after resection, represents an exceedingly rare iatrogenic complication. Case Description: A 68-year-old male, who had undergone decompressive craniectomy followed by staged bilateral TMC 5 years earlier for traumatic brain injury, presented with a solitary scalp mass that had been noted 1 year prior. Six months after the mass was resected, the patient developed an epidural abscess. Pathological examination confirmed the diagnosis of an EC, chronic inflammation, and Staphylococcus epidermidis growth. Conclusion: This case suggests that the EC and subsequent abscess were likely related to the prior TMC, highlighting this clinical course as a rare but serious iatrogenic complication of the procedure.