[A case of recurrent-rupture dermoid cyst].

A 58-year-old man was seen because of general convulsions. The neurological findings were normal at his first visit, but CT revealed a low density mass in the right hypothalamus with calcification. T1-weighted image revealed multiple high intensity lesions in the subarachnoid space. Only anti-epileptic drugs were prescribed. He was readmitted one year later because of a traffic accident due to convulsions. CT and MRI revealed other new lesions in the bilateral anterior horn. After four uneventful years, follow-up CT revealed a dilation of the third ventricle. MRI using the fat suppression method showed enhancement around the main tumor and the wall of the lateral ventricles and stenosis of the aqueduct. Right frontotemporal craniotomy was performed. Thickening of the arachnoids and floating lipid droplets were seen in the sub-arachnoid space. A yellowish tumor was found in the suprasellar region, adhering to the internal carotid artery. The tumor contained soft yellowish tissue and hair. Only partial removal was carried out because of severe adhesion to perforators. The lamina terminalis was opened after tumor removal. The postoperative course was uneventful except for transient diabetes insipidus.