Nasofrontal Dermal Sinus with Intradiploic Epidermoid Cyst: Case Report

Abstract

Nasofrontal dermal sinuses are very rare and generally occur in children. This congenital malformation can be revealed by midface swelling, local infection or neuromeningitis which make it a life-threatening disease. The case of a two-yearold boy who presented with spontaneously regressive orbitonasal soft tissue swelling is presented. Physical examination found a puncture hole letting out thick yellow substance at the nasal base. Computed tomography revealed a thickening of subcutaneous soft tissue and a frontal bone defect. Magnetic resonance imaging showed atrans-osseous tract with an Intradiploiccyst. The patient underwent a total excision of her dermal sinus along with the resection of the cyst via a trans-facial approach. The inner bone layer of the skull was intact. Pathological examination confirmed the diagnosis of dermal sinus associated with an Intradiploic epidermoid cyst. The postoperative course was uneventful. The case reported in this article represents a genuine example of the possible association of a nasofrontal dermal sinus with an Intradiploic epidermoid cyst and that a trans-facial approach is suitable to address the two lesions at the same time with good cosmetic result.