Case Of Epidermoid Cyst Research Articles

Oral epidermoid cyst: clinicopathological report of a rare case

Background: Epidermoid cyst of the oral cavity is very rare, slow-growing, benign neoplasm derived from the remnant of the neural tube. It accounts for less than 0.01% of all cystic lesions of the head and neck. Most of the intraoral cases are reported in the midline and floor of the mouth. Very rare cases are seen involving the tongue, lips, uvula, temporomandibular joint, maxillary, and buccal mucosa. The rare oral lesion is asymptomatic, but large masses present early with difficulty in breathing and swallowing. We report an uncommon case of epidermoid cyst in an infant with failure to thrive due to obstruction and inability to latch breast milk. Case report: A 40-day-old male infant presented with a large oral swelling in the floor of the mouth since birth. It measured 4 × 5 cm in size. Surgical excision with primary closure was successfully performed. The histopathological report confirmed the diagnosis of epidermoid cyst. The child recovered to full general health with no signs of recurrence. Conclusion: Oral epidermoid cyst is a rare neoplasm that may mimic dermoid cyst and teratoid tumors clinically. The treatment of choice is surgical excision; however, there is a recurrence rate of 33% and rarely transforms into malignancy.

Diagnóstico e tratamento de cisto epidermoide: relato de caso

O cisto epidermoide é um cisto de desenvolvimento não odontogênico relativamente comum e que tem origem relacionada a implantação de restos epiteliais durante a fusão dos processos embrionários. O presente artigo tem como objetivo relatar um caso de cisto epidermoide em região mandibular, com ênfase no seu diagnóstico e conduta clínica. O paciente adulto jovem, apresentou aumento de volume em região de corpo mandibular direito. A lesão foi removida por meio de excisão cirúrgica simples, sob anestesia local, e a peça encaminhada para análise histopatológica, afim de confirmar a hipótese clínica de cisto epidermoide. Durante o acompanhamento não foram necessárias reintervenções, demonstrando que se trata de uma lesão de fácil resolução, por meio de um procedimento cirúrgico simples.

Analysis of High-Frequency Ultrasound in the differential Diagnosis of Lumps in Foot and Hand

Objective: To investigate the ultrasonogram characteristics of common lumps in hand and foot, pursuing for greater understanding of hand and foot lumps. Methods: 65 cases of ultrasonographic characteristics of lumps in hand and foot were retrospectively analyzed, including the location, size, shape, boundary, internal echo and posterior echo, surrounding relationship and blood flow. Results: Among 65 cases, there were 26 cases of tendon sheath cyst, 16 cases of tenosynovitis giant cell tumor, 10 cases of hemangioma, 4 cases of tendon sheath fibroma, 3 cases of epidermoid cyst, 2 cases of Schwannoma, 2 cases of fibrolipoma, 1 case of angiolipoma and 1 case of neurofibroma. The preoperative and postoperative pathological diagnoses of 45 cases, accounting for 69.23%, were consistent, 3 cases (4.62%) were misdiagnosed, which included that 2 cases of tenosynovitis giant cell tumor were misdiagnosed as tendon sheath cyst, 1 case of neurofibroma as epidermoid cyst, and the preoperative diagnosis of the rest 17 cases(26.15%) were indefinite. Conclusion: The high-frequency ultrasound can diagnose properties of lumps in foot and hand well, providing diagnosis basis for further treatment in clinic.

Epidermoid cyst: A single-center review of 432 cases.

Background Epidermoid cysts are benign tumors derived from the infundibular portion of hair follicles and thus have a flattened surface epithelium and keratohyaline granules. They can occur at any age but are most frequently reported in adults, and more often occur in men than women. Most epidermoid cyst operations are performed for cosmetic purposes, or to relieve inflammation. The definitive treatment is complete excision or destruction of the cyst. The aim of this study was to improve understanding of epidermoid cysts.Methods We analyzed 432 cases of epidermoid cyst in 398 patients that underwent complete excision and biopsy between April 2001 and March 2020, according to patient age, patient gender, and lesion location.Results From all epidermoid cyst excisions performed, 17.6% were for patients in their 40s and 50s, 16.8% for those in their 20s, 16.1% for those in their 30s, 14.6% for those aged 60 or older, 5.0% for teenagers, and 0.5% for those under 10 years. Cases of epidermoid cysts occurred at a men-to-women ratio of about 3:2, with 59.5% of cases in men and 40.5% in women. By lesion location, 65.0% of cases were on the face, 10.9% on the trunk, 7.9% on the scalp, 7.9% on the neck, 4.3% on lower extremities, 3.9% on upper extremities, and 0.2% on genitalia. On the face, 20.8% of cases were on the cheek, 12.7% on the periauricular area, 10.9% on the periorbital area, 6.0% on the frontal area, 5.6% on the mental area, 3.7% on the perioral area, 2.8% on the nasal area, and 2.5% on the temporal area.Conclusion The proportion of women with epidermoid cysts was higher in our study than in previous studies. Moreover, the results showed that surgery has been on the rise in recent years, with facial surgery being the most common.

Clinical and pathological analysis of 64 patients with primary neoplasms of the lacrimal drainage system

Objective: To analyze the pathological classification and age distribution of primary neoplasms of the lacrimal drainage system. Methods: Retrospective case series study. A total of 64 patients (65 eyes) were diagnosed with primary neoplasms of the lacrimal drainage system and received surgery at Tianjin Eye Hospital from January 2006 to December 2016. All the clinical data of the patients were analyzed, including gender, diseased eye, age, clinical manifestations, composition of benign and malignant masses, and prognosis. The histopathological composition and age distribution of patients with primary lacrimal mass, lacrimal duct mass and lacrimal sac mass were analyzed according to the different diseased sites. Results: Twenty-three patients (24 eyes) were male, and 41 patients (41 eyes) were female. The right eye was involved in 36 patients, the left eye in 27 patients, and both eyes in one patient. The age at diagnosis ranged from 12 to 78 years old [mean, (46±4) years]. The course of disease was (13.1±4.2) months, ranging from 1 month to 7 years. The chief complaint was tear discharge in 43 patients, tumor in 19 patients, and abscess discharge in 2 patients. There were 29 patients with angular displacement and 21 patients with swelling pain. There were 51 patients with benign lesions, 4 with borderline lesions, and 9 with malignantlesions. These neoplasms consisted of primary peripunctal neoplasms in 17 patients, primary canalicular neoplasms in 2 patients, and primary lacrimal sac neoplasms in 45 patients. All primary peripunctal neoplasms (17 cases) were benign, among which nevi (10 cases) occupied the first place. All primary canalicular neoplasms (2 cases) were benign, there were 1 case of epidermoid cysts and 1 case of degenerative disease. Among the primary benign lacrimal sac masses (32 cases), mucous epithelial cysts (9 cases), dermoid cysts (6 cases), and epidermoid cysts (6 cases) occupied the first three places. Among the primary borderlin lacrimal sac masses (4 cases), there were 2 cases of giant cell tumor of soft tissue, 1 case of solitary fibrous tumor, and 1 case of inflammatory myofibroblastic tumor. The primary malignant mass of lacrimal sac (9 cases) was dominated by squamous cell carcinoma (3 cases). In terms of age distribution, the patients with primary peripunctal mass were mainly in the group of 40-59 years old (14 cases). The primary benign mass of lacrimal sac mainly occurred in the group of less than 40 years old (15 cases) and the group of 40-59 years old (11 cases). The patients with primary lacrimal sac borderline and malignant masses were all in the groups of over 40 years old. A total of 49 patients were followed up for 27 months to 16 years. The average follow-up time was (57.2±3.8) months. Lacrimal sac transitional cell carcinoma relapsed 7 months after surgery in one patient, and lacrimal sac melanoma relapsed 1 year after surgery in one patient. The patients did not relapse in 24 months and 38 months after surgery respectively. There were no recurrence of other cases. Conclusions: Primary peripunctal neoplasms are mostly characterized with benign lesions, among which nevi are most common. Mucous epithelial cysts, epidermoid cysts, and dermoid cysts are the major benign lacrimal sac neoplasms. Squamous cell carcinomas are the most common malignant lacrimal sac neoplasms. The malignant tumor of lacrimal sac often occurs in the middle-aged and elderly patients. (Chin J Ophthalmol, 2020, 56: 364-369).

A Case of Epidermoid Cyst of the Cecum Treated by Laparoscopic Resection

症例は，46歳，女性．右卵巣囊腫の診断で手術を施行したところ，両側卵巣は正常で盲腸に腫瘤を認めた．精査目的に当科紹介となった．腹部MRIおよびCT検査では，骨盤腔右側に約50mm大の囊胞性病変を指摘された．下部消化管内視鏡検査では，盲腸前方に壁外圧排所見があり粘膜下腫瘍が疑われた．腹腔鏡下に観察したところ，盲腸に腫瘍を認め，周囲との癒着はみられなかった．後腹膜から授動後体外へ引き出し，回盲部切除を行った．摘出標本では腫瘍は50×55mm大で弾性軟であった．病理組織的学診断の結果は，内部にケラチン物質を充満した単房性の囊胞性腫瘍で，腫瘍内面には皮膚附属器を伴わない表皮が認められ，epidermoid cystと診断された．盲腸内腔とは交通を認めなかった．

Epidermoid cyst of the urinary bladder: a case report

Epidermoid cyst of the bladder is a very rarely encountered benign lesion. Up to our knowledge, we present the second case of epidermoid cyst of the urinary bladder in literature. We report a case of epidermoid cyst developed in a 59-year-old patient followed up with bladder tumor.

Giant Epidermoid Cyst of the Bony External Ear Canal - A Rare Case Report

We describe a case of epidermoid cyst of the external ear canal. Although the outer ear canal was almost filled by the cyst, no bone erosion was observed. Dimensions of epidermoid cyst was 13 × 10 mm. According to our knowledge, this case is the biggest epidermoid cyst of the bony external ear canal in the literature.

Mixed Signal Intensity on Preoperative T1 MRI Might be Associated with Delayed Postoperative Hemorrhage in Patients with Intracranial Epidermoid Cyst

Delayed postoperative hemorrhage (DPOH) was a severe postoperative complication after intracranial epidermoid cyst (EC) surgery. This study was designed to investigate possible clinical data andimage features related to DPOH in patients with EC. We retrospectively investigated 186 cases of EC, and 8 cases presented an appearance of DPOH. Preoperative magnetic resonance imaging (MRI) and clinical data (age, sex, chief surgeon, tumor size, tumor location, and degree of resection) were reviewed and analyzed. The Student t test and the χ2 test were used, and statistical significance was defined as P < 0.05. A total of 8 patients suffered from DPOH. Seven patients (87.5%) with DPOH showed atypical mixed signal intensity on preoperative T1 MRI compared with typical low intensity in another DPOH case. Only 1 case of mixed signal intensity on T1 MRI was found in 178 patients without DPOH. The mixed signal intensity on preoperative T1 MRI was highly related to DPOH and mortality (both P < 0.001). There was no significant difference in other relative clinical data between patients with or without DPOH. Mixed signal intensity on preoperative T1 MRI might be associated with DPOH in patients with EC. The surgeon should pay more attention to this rarely atypical imaging before surgery. Further observations are necessary to illustrate the relationship between mixed signal intensity and DPOH in EC and to guide reasonable therapy.

Signos de alarma en neuralgia del trigémino

La neuralgia del trigémino es característica en personas mayores de 50 años, comprometiendo principalmente el territorio V2 y V3 de dicho nervio de manera unilateral y la carbamezepina es el fármaco con mayor efectividad, pero no siempre responden. La presentación atípica y los signos de alarma ponen en consideración el estudio con resonancia magnética cerebral, pues obliga a descartar una causa secundaria, siendo necesario el análisis de neuroimágenes. Debido a esto, presentamos un caso de quiste epidermoide con neuralgia secundaria, que se presenta con signos de alarma y se deben considerar los estudios complementarios.

Organ-sparing partial orchietectomy for testicular adenomatoid tumor

The incidence of testicular tumors is relatively low which are mainly malignant, so the main way to treat testicular tumors is radical testicular resection. Testicular adenomatoid tumor is a rare testicular benign tumor, but is easily misdiagnosed as malignant tumors with removal of organs. This article aims to explore the clinical features of testicular adenomatoid tumor and its treatment. There were 133 cases of testicular tumor in the Peking University Third Hospital from May 1994 to November 2016. We conducted a retrospective analysis of three patients who underwent the treatment of partial orchiectomy with preservation of the organ and were pathologically diagnosed with testicular adenomatoid tumor after surgery. The follow-up was done by outpatient clinics and telephone inquiry after surgery. The related literature was also reviewed for further discussion. Of all the 133 patients, 116 had radical resection of the testis and 17 had partial testicular resection due to specific reasons (5 cases of epidermoid cyst, 4 cases of teratoma, 3 cases of seminoma, 3 cases of adenomatoid tumor, and 2 cases of Sertoli cell tumor). The mean age of the 3 patients was (42.67±10.97) years (30-49 years), the mean hospital stay was (9.00±5.20) d (6-15 d), the mean body mass index was (26.20±1.42) kg/m2 (25.00-27.76 kg/m2), the mean serum human choionic gonadotophin (HCG) was (1.15±0.11) IU/L (1.07-1.23 IU/L) (all normal) and the mean serum alpha-fetoprotein (AFP) was (2.12±0.66) μg/L (1.65-2.58 μg/L) (both were normal). Ultrasound features revealed a clear or unclear border, solid, moderate echo nodule tumor in the testis. The mean maximal diameter of the tumor was (1.00±0.44) cm (0.50-1.30 cm), and the mean duration of intraoperative warm ischemia time was (19.67±17.10) min (0-31 min) (only the last two cases). No recurrence or malignant transformation was observed during the follow-up. Testicular adenomatoid tumor is mainly based on the characteristics of ultrasound to determine preoperatively, but easy to be misdiagnosed with testicular radical resection. The recommended surgery for adenomatoid tumor is partial resection of the testis via the inguinal approach according to the frozen section pathology to determine whether to retain the organ.

Accuracy of magnetic resonance imaging in evaluation of sellar and juxtasellar tumors

Background: Sellar and parasellar/juxtasellar regions are complex areas of the brain, and different varieties of tumors can occur in this area. Preoperative noninvasive diagnosis with magnetic resonance imaging (MRI) is essential for treatment planning. Aim of the Study: The aim of this study is to characterize MRI features of the sellar and juxtasellar tumors and to correlate MRI diagnosis with histopathological diagnosis in order to evaluate the efficiency of MRI. Materials and Methods: Patients with sellar and juxtasellar lesions who were operated during September 2015–August 2017 and the pathological reports were compared with the MRI findings retrospectively. Results: A total of 50 patients were enrolled in the study, and the mean age of presentation was 34.6 years. MRI-based radiological diagnosis showed 21 cases of pituitary macroadenoma, 15 cases of craniopharyngioma, 9 cases of meningioma, 2 cases of germinoma, 1 case of glioma, and 2 cases of epidermoid cysts. Histopathological correlation revealed MRI accuracy of 94.12%, 94%, 100%, 98%, 100%, and 100% for the diagnosis of pituitary macroadenoma, craniopharyngioma, meningioma, germinoma, glioma, and epidermoid cyst, respectively. One case each of pituitary macroadenoma and germinoma diagnosed on MRI comes out to be as craniopharyngioma after final histopathological correlation, whereas one case of craniopharyngioma turned out to be macroadenoma after final histopathological examination. Conclusions: The present study revealed a strong correlation between MRI and histopathological diagnosis for sellar and juxtasellar tumors. MRI is the modality of choice for characterizing sellar and suprasellar lesions.

A Rare Case Report of Epidermoid Cyst in Palatine Tonsil

Epidermoid cysts (ECs) are benign lesions that can be encountered anywhere in the body as congenital or acquired. In oral cavity, the most common affected site is floor of mouth but the incidence of ECs arising in the tonsil is very rare. Though it is extremely rare, EC should be considered as a differential diagnosis of tonsillar masses. Also otolaryngologysts should be differentiate it from the tonsillar neoplasia due to similar appearance. We aimed to report the case of EC arising in the tonsil which was encountered as a tonsillar mass. Also we discussed role of histopathology in such rare lesions.

Epidermal inclusion cyst in an intra-pancreatic accessory spleen: a case series and review of the literature

Introduction: An epidermoid cyst in an intra-pancreatic accessory spleen (ECIPAS) is a rare lesion. A review of the English literature showed that very few cases were reported worldwide. Most of the cases are diagnosed post-operatively after surgical resection based on a pre-operative diagnosis of a possible pancreatic malignancy. Methods: A MEDLINE database review of the relevant medical literature published and identified all reported cases of ECIPAS were conducted with the following key words: epithelial cyst, pancreas and intra-pancreatic accessory spleen. Relevant publications were evaluated and demographic data, imaging findings as well as management options were collected. Results: We found 39 articles describing this clinical condition, with the largest series described containing 3 cases. In this series, we present 2 cases of epidermoid cysts arising from an intra-pancreatic accessory spleen. Conclusion: It is important to consider the differential diagnosis of epidermoid cyst in an intra-pancreatic accessory spleen in management of cystic neoplasms of the pancreas.

Giant Epidermoid Cyst of the Maxillary Sinus: A Postoperative Complication?

Epidermoid cysts are benign lesions, which are usually detected on the floor of the mouth in the head and neck region. They can develop from abnormal epithelial components of an ectoderm tissue during the embryological life or alternatively they can arise from the implanted epithelium after trauma or surgery. The diagnosis of an epidermoid cyst in the maxillary sinus can be challenging and it could be easily mistaken for any benign or malign lesion of the nasal cavity and paranasal sinuses. In this case, we present a 44-year-old man with a giant epidermoid cyst in the right maxillary sinus with a previous history of paranasal sinus surgery. We present a very rare case of epidermoid cyst and also discuss the importance of radiological imaging modalities in differential diagnosis of a unilateral expansile mass in the maxillary sinus.

Squash Smear Technique in Rapid Intraoperative Diagnosis of Non-neoplastic and Cystic Lesions of CNS

In neurosurgical practice, a rapid intraoperative diagnosis helps the neurosurgeon to monitor and modify the approach at surgery. Smears and frozen sections are the two rapid tissue preparations that may be used by neuropathologists for giving opinion on intraoperative biopsy specimens of suspected lesions. The smear technique, which could be either squash/crush smears or impression smears, has been applied in neurosurgical units worldwide. This method plays a very important role in the analysis of sample from craniotomies and the small specimens obtained from stereotactic biopsies. Squash smear technique is a very rapid technique and the study was designed to assess the accuracy of squash smear in the rapid intraoperative diagnosis of non-neoplastic and cystic lesions of CNS and to document the cytomorphology of these lesions. A total of 23 cases were studied. The tissue was removed at craniotomy or by burr hole biopsy. In all the cases clinicoradiological correlation was done with smear diagnosis. Smears were stained with 1% Toluidine blue and H&E. In all cases, results were compared with the paraffin section prepared from the tissue remaining after the squash smears. Immunohistochemistry was done in one case. Special stains were used as required. Amongst non-neoplastic lesions, tuberculous lesions comprised the maximum number of cases (n=9), two cases of PML, one case of fungal lesion, one case of non-specific abscess, one case of infarct, only reactive changes in one and normal cortex and white matter in one. In cystic lesions of the CNS, there was one case of Rathke’s Cleft cyst, four cases of Epidermoid cyst and two cases of arachnoid cyst. Cases of PML and Rathke’s cleft cyst could not be identified on smears. In all the cases, smear diagnosis was compared with histopathological diagnosis.

A case of epidermoid cyst of distal phalanx of the right ring finger

A case of epidermoid cyst of distal phalanx of the right ring finger

Multi-Segmental Intramedullary Epidermoid Cyst Causing Low Back Pain and Urologic Dysfunction

Introduction: Epidermoid cysts (ECs) are rare, slow growing tumors which usually affect lumbosacral area as an extramedullary lesion and mostly associated with spinal malformations. In this report we describe a very rare case of multi-segmental intramedullary EC. Case Presentation: A 42- year-old male presented with low back pain and paresthesia of left lower limb and also intermittent urinary retention. Urodynamic study showed weak contractions in bladder. MRI demonstrated multi-segmental lobulated intramedullary lesion extending from C7 to L2, which has high intensity on both T1 and T2-weighted images. Laminectomy of T11-L3 for symptomatic parts of the lesion and subtotal resection of the tumor was performed and histopathological investigation confirmed EC. Conclusions: Prompt evaluation of every patient with combination of neurological and urologic disturbances should be carried out. This report suggests that rare intraspinal tumors such as EC may affect multiple locations of the spinal cord, thus appropriate surgical intervention may prevent unwanted sequelae.

A Case of Epidermoid Cyst of the Pancreas: Can Surgery be Avoided?

A Case of Epidermoid Cyst of the Pancreas: Can Surgery be Avoided?

A rare case of intradural and extramedullary epidermoid cyst after repetitive epidural anesthesia: case report and review of the literature

BackgroundSpinal epidermoid cysts are benign tumors, which are rarely seen as an intradural extramedullary spinal cord tumor in the conus medullaris region. Acquired spinal epidermoid cysts are mostly caused by iatrogenic procedures, such as lumbar puncture, and the majority of acquired spinal epidermoid cysts have been reported below the L1 level, because lumbar puncture is usually performed around the iliac crest. Here, we report an extremely rare case of an epidermoid cyst that occurred as an intradural and extramedullary spinal cord tumor attached to the conus medullaris after repetitive epidural anesthesia.Case presentationA 67-year-old female presented with a low back pain and left sciatica. Although the patient had experienced occasional mild low back pain for several years, her low back pain markedly worsened 2 months before her visit, as well as newly developed left sciatica resulting in intermittent claudication. She had a history of several abdominal surgeries. All abdominal procedures were performed under general anesthesia with epidural anesthesia in her thoracolumbar spine. Magnetic resonance imaging of her lumbar spine demonstrated an intradural extramedullary spinal cord tumor at the T12–L1 level. Because her symptoms deteriorated, the tumor excision was performed using microscopy. Histological examination of the specimens demonstrated that the cyst walls lined with stratified squamous keratinizing epithelium surrounded by the outer layer of collagenous tissue with the absence of skin adnexa. A diagnosis of epidermoid cysts was confirmed. Her MRI showed complete resection of the tumor, and there was no recurrence at 2-year follow-up.ConclusionsIn this case report, epidermoid cells might be contaminated into the spinal canal during repetitive epidural anesthesia. The patient was successfully treated by complete resection, and there was no recurrence at 2-year follow-up with a good clinical outcome. However, long-term follow-up is required for a potential risk of tumor recurrence.