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Mark Boughton: Epidermoid Cyst

Mark sits in his office. He has rounded glasses, and wears a black suit with a blue tie. He has white hair cropped short.

The Challenge: A Lemon-Sized Brain Cyst

Mark Boughton is a busy man. His daily routine as the mayor of Danbury, Connecticut consists of countless meetings, hundreds of phone calls and emails, and barely enough time to squeeze in a quick lunch.

Describing himself as an “extremely energetic person,” Mark was always ready to tackle whatever lay ahead of him. When he began having bouts of extreme exhaustion during the day, he knew something wasn’t right.

“I would get extremely tired in the middle of the afternoon, for no reason at all,” Mark says. “It wasn’t me. This wasn’t how my body functioned. But I just assumed it might have something to do with getting older.”


“We have great doctors and hospitals in this area,” Mark says. “But after speaking with Dr. Friedlander and learning more about his expertise, I knew that he was the right guy to remove the cyst." — Mark Boughton


As time went on, Mark continued to suffer from exhaustion. On top of that, he began having terrible headaches that would come and go. Then, something happened that made him extremely worried. He lost his vision for 25 minutes.

“It was an ordinary day and then, suddenly, I just lost my vision. I thought I was dying,” Mark says.

He immediately went to the emergency room, where doctors found a mass the size of a lemon inside his brain. The mass was later determined to be an epidermoid cyst, which forms during embryonic development. A cluster of skin cells gets trapped and grows slowly over the years, until the cyst starts to cause symptoms like the headaches, exhaustion, and vision loss that Mark experienced.

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The Path to Pittsburgh

Mark consulted with numerous doctors in the New England area and received a recommendation to see Dr. Robert Friedlander, chairman of the Department of Neurosurgery, in Pittsburgh. After doing his own research and talking to Dr. Friedlander on the phone, he knew UPMC was the place to go.

“We have great doctors and hospitals in this area,” Mark says. “But after speaking with Dr. Friedlander and learning more about his expertise, I knew that he was the right guy to remove the cyst.”

Mark made the trip to Pittsburgh and immediately began preparing for surgery.

The Solution: A Complex Surgical Approach

Because the cyst in Mark’s brain was surrounded by important brain tissue and arteries, Dr. Friedlander used an advanced brain imaging technology known as High Definition Fiber Tracking (HDFT) to view the detailed “wiring” of his brain fibers. This technology helped Dr. Friedlander and his team to determine the best way to execute the surgery while avoiding any damage to Mark’s brain.

During the six-hour surgery, Dr. Friedlander removed a small portion of Mark’s skull, and using the HDFT scans as a road, navigated around important brain structures to remove the cyst.

When Mark woke up in the intensive care unit, Dr. Friedlander was there to tell him that the cyst was completely removed.

“I shouted and pumped my fists when he told me that,” Mark says.

The Results: Back to City Hall

Two days after the operation, Mark left the hospital. He stayed at a hotel for another week for follow up and so that his stitches could be removed before he returned to Danbury.

As soon as he returned home, he picked up right where he left off – at City Hall.

“I wanted to get right back to work,” Mark says. “At first, I did only a few hours a day, but then I was able get right back to working full weeks, just like I had been before any of this started.”

Now, as Mark gears up for a potential run for governor, he’s thankful that the team at UPMC was able to remove the cyst and get him back to feeling 100 percent.

“I have an appreciation for life I’ve never had before,” he says. “Dr. Friedlander and everyone at UPMC were truly incredible and I can’t thank them enough. They’re the best in the world at what they do. Period.”


Our patient stories profile a number of people who have had minimally invasive brain surgery at UPMC. Although everyone's care experience is unique, we hope that sharing these stories will help other prospective patients and their families better understand these procedures and their potential benefits.

Mark's treatment and results may not be representative of all similar cases.

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