We report a case of a
dermoid cyst in the parasellar area associated with
porencephaly. A 22-year-old man presented with
headache and visual disturbance. Non-enhanced brain CT showed a high density mass in the parasellar area and a low density area in the left temporal lobe. On
gadolinium-enhanced T1-weighted images, a partial rim enhancement was present in the parasellar region. A presumptive diagnosis of
Rathke cleft cyst,
craniopharyngioma, non-function
pituitary adenoma, or
germ cell tumor was considered. A left frontotemporal
craniotomy was performed and the
tumor was removed almost totally. The
tumor was well-capsulated and contained whitish, milky debris. The histologic diagnosis was
dermoid cyst. The temporal lobe lesion was
porencephaly. The postoperative course was uneventful. Their most typical aspect is the presence of a low-density mass on CT, allowing an easy radiologic diagnosis of
dermoid cyst containing
lipids. Enhancement following contrast administration is uncommon. The hyperdensity may be related to the high
protein content of the lesion. The hyperdense aspect of the lesion on CT, and the presence of rim enhancement made the radiologic diagnosis of a
dermoid cyst difficult in this case. A case of
dermoid cyst associated with
porencephaly has not yet been reported in the literature.