Hemorrhagic skull epidermoid cyst in acute leukemia

Skull epidermoid cysts are unusual lesions and are frequently found incidentally. Sometimes, mass effect can be responsible for neurological symptoms. Exceptionally, they can be related to an epidural hematoma. We present a highly unusual case in which extra-axial bleeding occurred in the subdural space and intensification chemotherapy concurred as a risk factor. We discuss the possible mechanisms of the hemorrhage and the likely implication of the hematologic disease in the surgical management of skull epidermoids.