Dermoid Research Articles

Giant Sublingual, Submental, and Lingual Dermoid Cyst Restricting Tongue Movement Undiagnosed for Several Years

Giant Sublingual, Submental, and Lingual Dermoid Cyst Restricting Tongue Movement Undiagnosed for Several Years

Mature cystic teratoma with co-existent mucinous cystadenocarcinoma: describing a diagnostic challenge—a case report

BackgroundMature cystic teratoma co-existing with a mucinous cystadenocarcinoma is a rare tumor that few cases have been reported until now. In these cases, either a benign teratoma is malignantly transformed into adenocarcinoma or a collision tumor is formed between a mature cystic teratoma and a mucinous tumor, which is either primarily originated from epithelial-stromal surface of the ovary, or secondary to a primary gastrointestinal tract tumor. The significance of individualizing the two tumors has a remarkable effect on further therapeutic management.Case presentationIn this case, a mature cystic teratoma is co-existed with a mucinous cystadenocarcinoma in the same ovary in a 33-year-old Iranian female. Computed Tomography (CT) Scan with additional contrast of the left ovarian mass suggested a teratoma, whereas examination of resected ovarian mass reported an adenocarcinoma with a cystic teratoma. A dermoid cyst with another multi-septate cystic lesion including mucoid material was revealed in the gross examination of the surgical specimen. Histopathological examination revealed a mature cystic teratoma in association with a well-differentiated mucinous cystadenocarcinoma. The latter showed a CK7−/CK20 + immune profile. Due to the lack of clinical, radiological, and biochemical discoveries attributed to a primary lower gastrointestinal tract tumor, the immune profile proposed the chance of adenocarcinomatous transformation of a benign teratoma.ConclusionsThis case shows the significance of large sampling, precise recording of the gross aspects, histopathological examination, immunohistochemical analysis, and the help of radiological and clinical results to correctly diagnose uncommon tumors.

Pädiatrische Rhinologie.

The following review article highlights key topics in pediatric rhinology that are currently the focus in research and at conferences as well as in the interdisciplinary discussion between otorhinolaryngologists and pediatricians. In particular, congenital malformations such as choanal atresia or nasal dermoid cysts are discussed, followed by statements on the current procedures for sinogenic orbital complications as well as on the diagnosis and therapy of chronic rhinosinusitis in children. Furthermore, updates on the role of the ENT specialist in the care for children with cystic fibrosis and primary ciliary dyskinesia are provided.

Small bowel obstruction in ruptured male pelvic dermoid with situs inversus totalis: a singular case presentation

BackgroundPelvic dermoid cysts are extremely rare in males, with an even rare occurrence of rupture. Only a handful of cases of male pelvic dermoid cysts have been published with no reported case of ruptured male pelvic dermoid causing small bowel obstruction to the best of our knowledge.Case presentationHerein we report a case of ruptured pelvic dermoid presenting with intestinal obstruction in an adult male patient with situs inversus totalis.ConclusionPelvic dermoid cyst should be considered even in males the presence of classical radiological signs. Knowledge of usual and unusual imaging signs as well as the associated life-threatening complications of a ruptured dermoid cyst can help in prompt diagnosis and timely patient management.

Teratoid Cyst of the Floor of the Mouth: Case Report

Dermoid cysts are rare benign tumors of ectodermal origin, they are found in service-facial region with 7% of cases [1]. Floor of the mouth dermoid cysts is even more rare, and are generally localized in the median line of the genioglossus muscle [2]. They are classified as epidermoid cyst, real dermoid cyst and treated depending on the presence or not of the three embryologic contingents. We report the case of a giant congenital teratoid cyst of the floor of the mouth in a 5yo child.

Diagnostic dilemma – Ovarian dermoid cysts presenting with uncommon complications and a rare association

Mature cystic teratomas, also known as dermoid cysts, are commonly encountered ovarian tumors accounting for up to 10–25% of all ovarian neoplasms. Mostly asymptomatic and incidentally detected, they may present with associated complications such as torsion, rupture, malignant transformation, and infection. Fistulization of ovarian cysts into the bowel is a rare complication and occurs in cases of infection or malignant transformation. We present a rare case of an infected dermoid cyst with co-existing endometriosis and fistulization into the rectum in a 35-year-old female. The patient presented with fever, pain, and history of infertility. This article highlights the important differential diagnosis to be considered in a multiloculated ovarian cyst containing fat and pockets of air.

Functional outcomes in intradural extramedullary spinal tumors

Background: Intradural extramedullary (IDEM) spinal cord tumors account for approximately two-thirds of benign intraspinal neoplasms. These are amenable to gross total excision but can have variable functional outcomes, which plays a key role in assessing their impact on a patient’s quality of life. Understanding the functional outcomes associated with these tumors is crucial for healthcare professionals to devise appropriate treatment plans and provide comprehensive care. Methods: In this study, we retrospectively reviewed the outcomes of 130 patients with IDEM tumors who underwent surgery in the past six years between January 2017 and December 2022 at a single institution. Patient demographics, symptoms, and tumor characteristics (anatomical and pathological) in all operated spinal IDEM tumors were analyzed. The neurological findings obtained during the preoperative stage and the postoperative follow-up were evaluated according to the Frankel grading. The back pain was assessed using the Denis pain scale (DPS). Results: The age range, gender distribution, presentation, histopathology, and tumor characteristics were analyzed. The histopathological outcomes of the study were as follows: 56 cases of schwannoma, 37 cases of meningiomas, 16 patients of neurofibroma, six cases of epidermoid cyst, five cases each of ependymoma and dermoid cyst, three cases of arachnoid cyst, two cases of metastasis, and one case of paraganglioma. Pain was the most common symptom (38.5%), followed by weakness in limbs (31.5%), paresthesia/numbness (22.3%), and sphincter disturbance (7.7%). Complete total resection was seen in 93% of cases, with 7% undergoing subtotal excision. The complications encountered were – four cases of surgical site infection and one case each of cerebrospinal fluid leak, pseudomeningocele, and epidural hematoma. In our series, 49.3% of patients had significantly good improvement in functional outcomes as per improvement in Frankel score, and 43% of patients had good functional improvement. Significant functional improvement was noted at immediate postoperative follow-up, 2-week follow-up, and six-month follow-up periods. Reoccurrence was seen in 7 cases (5.4%). The DPS score mean values showed a significant decrease over the follow-up duration as compared to preoperative mean values. Significantly poor outcome was seen in IDEM tumours present anteriorly. Conclusion: The IDEM tumors are usually benign and are readily detected by contrast-enhanced magnetic resonance imaging scans. These have variable functional outcomes in different centers. Assessing this functional outcome is an essential aspect of managing IDEM spinal tumors. It was observed through our study that the ventral location of the tumor, thoracic tumors, and poor preoperative neurological status of the patient correspond with poorer postoperative functional outcomes. Furthermore, a significant decrease in the pain symptoms with improvement of Frankel score was seen postoperatively, thus this being suggestive of a significant improvement of functional outcome after surgery. This study helps to conclude that the morbidity associated with the resection of IDEM tumors is not as significant as originally thought to be.

[Testicular tumor in a9-year-old boy].

A9-year-old boy presented to the emergency department after noticing apainless mass on the right testicle during self-examination in the shower. On physical examination, both testes were mobile and painless, with the right testis twice as big as the left and exhibiting palpable resistance. Sonographic examination revealed auniformly demarcated mass with aventral protrusion on the right testis. Tumor markers and blood tests were normal. The testis was exposed inguinally and the tumor was enucleated, which revealed adermoid cyst. The testicle could thus be preserved. Final histology confirmed complete excision of the benign dermoid cyst (mature teratoma). As testicular tumors in prepubertal boys are rare and usually benign, an organ-preserving procedure with perioperative biopsy should be aimed for. Due to the rarity of studies on recurrence after organ-preserving testicular surgery, we recommended regular ultrasound examinations during the first year after surgery, followed by annual examinations for aperiod of 5years.

Dermoid cyst of the auricle

Dermoid cyst of the auricle

Dermoid cyst management and outcomes: A review of over 1,000 cases at a single institution

BackgroundMature cystic teratomas represent nearly 60% of benign ovarian neoplasms across all age groups. We aim to update existing descriptive studies of ovarian teratomas including the epidemiology, rate of torsion/malignancy, and treatment modalities in a large modern cohort of patients. Study DesignThis is a retrospective cross-sectional study of all pathology-confirmed cases of ovarian teratoma who underwent surgery at one tertiary care institution from 2004–2015. Patient demographics, ovarian cyst characteristics, surgical approach and timing, rate of spillage, and surgical complications were examined. Results1,054 cases of ovarian teratoma were identified during the study period. There were 113 cases of bilateral teratoma (10.7%). Mean age at diagnosis was 38 years. Average cyst size was 6.26cm. The overall rate of torsion was 5.6%, with a higher rate of torsion with increasing cyst size. Over 70% of cases were treated with minimally invasive surgery, which was associated with decreased perioperative complications but an increased risk of cyst spillage. Among 394 patients with cyst spillage, only one developed chemical peritonitis. The malignant transformation rate of mature cystic teratoma in this cohort was 1.1%. This cohort included 100 pregnant women with mature teratoma. Pregnant patients were more likely to have minimally invasive surgery in the 1st trimester and more likely to undergo laparotomy in the 2nd or 3rd trimester. ConclusionsIn this large modern cohort, we found similar rates of bilaterality, torsion, malignant transformation, and struma ovarii in ovarian teratomas when compared to previous literature. Most cases of ovarian teratoma can be managed laparoscopically, which is associated with a lower surgical complication rate. Despite increased risk of cyst spillage with a minimally invasive approach, chemical peritonitis is a rare complication.

Traumatic Rupture of Dermoid Cyst in Early Pregnancy: Diagnosis and Management in Peki Government Hospital Resulting in a Successful Delivery at Term

Introduction: Dermoid cyst is the commonest germ cell tumour, constituting about 20% of adult ovarian tumours. They are mostly asymptomatic, but complications such as torsion, rupture, and malignant transformation have been reported. Only a few cases of ruptured mature cystic teratoma in early pregnancy have been described and even fewer are those in early pregnancy with the pregnancy successfully carried to term with successful delivery. Case Presentation: We present a case of a grand multiparous woman who presented to Peki Government Hospital at 11 weeks gestation with an acute abdomen following a fall. She had been diagnosed with a dermoid cyst a week with dimensions of 20cm x15 cm before the presentation. Ultrasound diagnosis of a possible rupture of the cyst was made on admission. Right oophorectomy was done at laparotomy. She had progesterone support for the succeeding 4 weeks and the pregnancy was successfully carried to term with good outcomes at delivery for both mother and baby. The APGAR score for the baby at 1minute and 5minute after birth were 7/10 and 8/10 respectively. Conclusion: Traumatic rupture of dermoid cyst should be considered as a differential diagnosis in women presenting with acute abdomen in early pregnancy. Laparotomy with abdominal lavage is a viable management option in a low-resource setting.

Schwannoma of Facial Region: A Pathology Often Missed in the Initial Diagnostic Hypothesis: A Case Report

Schwannoma, also known as neurilemmoma, is a benign tumor originating from Schwann cells and may involve any nerve in the body but its most common occurrence is in the head and neck region. When it involves a nerve of face, it is often confused with dermoid cyst. We present the case of a 23-year-old male patient with Schwannoma arising from the area just below the lateral canthus of the left eye where the initial diagnostic hypothesis was dermoid cyst but later confirmed as Schwannoma on histopathological analysis.

A giant dermoid cyst in the floor of the mouth: a case report

Dermoid cysts are slow-growing cystic masses that are lined by stratified squamous epithelium and contain skin appendages. Dermoid cysts in the floor of the mouth account for less than 0.01% of all neck and oral cavity cysts. They can be either congenital or acquired. We report a case of a 25-year-old male, a final-year engineering student, who came to our outpatient department with complaints of swelling in the mouth and weight loss for 4 years. On examination, a large cystic swelling in the floor of the mouth, approx. 5x6 cm, obscuring the oropharynx, was seen. USG and CECT of the neck suggested ranula and plunging ranula in the right submandibular space, respectively. He underwent a combined (debulking and enucleation) submandibular cystic swelling excision through a transoral approach under general anesthesia guided by awake fiber optic nasal intubation. The intraoperative and postoperative periods were uneventful. Histopathologic examination of the resected tissue specimen suggested a dermoid cyst. The patient recovered well during the 1-month follow-up, and he gained weight up to 2.5 kg in a month of treatment. Dermoid cysts are very rare cystic lesions on the floor of the mouth. Surgery is the most curable method of treatment. A proper clinical examination with imaging guidance is necessary for accurate delineation of the cyst. Large submandibular cystic lesions can be excised by combining debulking and enucleation through a transoral approach, with a good cosmetic and functional outcome.

Ovarian dermoid cyst in a buffalo

AbstractOvarian dermoid cyst is characterised by the presence of hair follicles, sebaceous glands grossly observed as clusters of matted hair in greyish cheesy material in the vicinity of ovaries. Upon examination of 235 buffalo genitalia, five were found to have abnormal ovarian texture and were relatively large in size. Further investigation revealed presence of dermoid cyst in these ovaries. Histopathological analysis showed degenerated primary, secondary and tertiary/Graafian follicles in the ovarian parenchyma, with patches of neuro‐ectodermal rosette‐like structures composed of glial cells. Other extra‐gonadal tissues often less organised were also observed like cartilage, fibrous connective tissue and glandular structures. In two of the specimens, corpus luteum with degenerated luteal cells was also present in the parenchyma of the ovary. These detailed investigations pointed to the infertility problems in buffaloes associated with this condition and often dictated in slaughterhouse‐derived ovaries. It has clinical significance as these structures are often confused with cystic ovarian disease upon rectal palpation, and treatment is unsuccessful in reducing the size of the ovary at the field level.

Growing Pains: A Rare Case of a Temporal Dermoid Cyst in an Adult and Review of the Literature

Dermoid cysts are common cutaneous developmental anomalies that occur due to the entrapment of ectodermal elements during embryonic closure. While the exact origin of dermoid cysts is unknown, they are theorized to originate from multipotent embryonic stem cells or translocated epithelial cells. Dermoid cysts are typically congenital but are sometimes diagnosed later in childhood and rarely in adulthood. They are reported as the most common pediatric skull tumors. Surgical excision is recommended to prevent enlargement, invasion, rupture, or infection. Temporal dermoid cysts, specifically, are extremely rare, with only a few cases having been reported in adulthood. We present a case of a 51-year old female with an enlarging left temporal mass found to be a dermoid cyst. The mass was excised, resulting in complete resolution of symptoms. This case highlights the importance of early excision, radiologic studies, and a tailored management approach based on cyst location. Our proposed treatment algorithm provides guidance for clinicians in identification and management of adult dermoid cysts.

A Rare Presentation of Occipital Dermoid Cyst with Intracranial Extension and Secondary Infection: Case Report and Follow-Up

AbstractCraniofacial dermoid cysts are congenital anomalies that rarely have intracranial extension and can be associated with other anomalies. Common sites of these lesions are the lateral brow and parietal scalp. Presentation of the dermoid cyst in the occipital region with intracranial extension is extremely rare. We report a 2-year-old female with a presentation of an occipital dermoid cyst with intracranial extension and secondary cerebellar abscess. This case highlights the rarity of the presentation of an occipital dermoid cyst with intracranial extension and secondary infection and the importance of early imaging for suspected dermoid cysts in the occipital region for identification of intracranial extension.

Prevalence of surgical affections of sheep in Mymensingh division of Bangladesh

Background: This study aimed to investigate the occurrence of surgical conditions in sheep and analyze their distribution based on age, sex, sheep, and seasonal variation. Methods: Retrospective data on surgical conditions in sheep were compiled from Upazila Livestock Offices and Veterinary Hospitals within Mymensingh division between January 2021 and December 2021. Simple descriptive statistics were used for data analysis. Results: A total of 788 surgical cases in sheep were documented. The predominant surgical conditions observed in sheep included wounds (29.18%), myiasis (15.10%), bloat (14.08%), subcutaneous cysts (12.56%), and foot rot (8.24%). In addition, there were instances of abscesses (6.47%), horn fractures (4.56%), atresia ani (3.93%), dermoid cysts (1.64%), dog bites (1.90%), overgrown hooves (1.52%), and gangrenous mastitis (0.63%). Surgical affections were more prevalent in adult sheep (73.35%) compared to young ones (26.64%). Among adult sheep, myiasis, bloat, subcutaneous cysts, and foot rot showed higher prevalences. In females, myiasis, subcutaneous cysts, bloat, and abscesses occurred more frequently than in male sheep. The occurrence of surgical affections was relatively higher in adult sheep during the rainy season, followed by summer, autumn, and winter during the rainy season followed by summer, autumn, and winter. Conclusion: The findings of this study highlight the variable demographic distribution of surgical affections in sheep. The observed patterns suggest that the surgical disorders pose a substantial threat to sheep rearing in the study areas.

Ultrasound radiomics-based artificial intelligence model to assist in the differential diagnosis of ovarian endometrioma and ovarian dermoid cyst.

Accurately differentiating between ovarian endometrioma and ovarian dermoid cyst is of clinical significance. However, the ultrasound appearance of these two diseases is variable, occasionally causing confusion and overlap with each other. This study aimed to develop a diagnostic classification model based on ultrasound radiomics to intelligently distinguish and diagnose the two diseases. We collected ovarian ultrasound images from participants diagnosed as patients with ovarian endometrioma or ovarian dermoid cyst. Feature extraction and selection were performed using the Mann-Whitney U-test, Spearman correlation analysis, and the least absolute shrinkage and selection operator (LASSO) regression. We then input the final features into the machine learning classifiers for model construction. A nomogram was established by combining the radiomic signature and clinical signature. A total of 407 participants with 407 lesions were included and categorized into the ovarian endometriomas group (n = 200) and the dermoid cyst group (n = 207). In the test cohort, Logistic Regression (LR) achieved the highest area under curve (AUC) value (0.981, 95% CI: 0.963-1.000), the highest accuracy (94.8%), and the highest sensitivity (95.5%), while LightGBM achieved the highest specificity (97.1%). A nomogram incorporating both clinical features and radiomic features achieved the highest level of performance (AUC: 0.987, 95% CI: 0.967-1.000, accuracy: 95.1%, sensitivity: 88.0%, specificity: 100.0%, PPV: 100.0%, NPV: 88.0%, precision: 93.6%). No statistical difference in diagnostic performance was observed between the radiomic model and the nomogram (P > 0.05). The diagnostic indexes of radiomic model were comparable to that of senior radiologists and superior to that of junior radiologist. The diagnostic performance of junior radiologists significantly improved with the assistance of the model. This ultrasound radiomics-based model demonstrated superior diagnostic performance compared to those of junior radiologists and comparable diagnostic performance to those of senior radiologists, and it has the potential to enhance the diagnostic performance of junior radiologists.

Presentation and treatment of two cases of malignant struma ovarii

BackgroundMalignant Struma Ovarii (MSO) is a rare type of germ cell tumour which is diagnosed postoperatively on surgical pathology specimens by the presence of differentiated thyroid cancer in mature cystic teratomas in the ovaries. Treatment and follow-up procedures are not clearly established due to the paucity of MSO cases.Case 1A 44-year-old multiparous female presented with an irregular period. Ultrasound showed a left ovarian lesion mostly a dermoid cyst, however, CT showed a 3.8 × 2.7 × 4 cm complex cystic lesion with thick septation and enhancing soft tissue component. Laparoscopic left salpingo-oophorectomy was performed and histopathology showed a follicular variant of papillary thyroid carcinoma arising in a mature cystic teratoma. Peritoneal cytology was positive for malignancy. A thyroid function test was normal before surgery. Total thyroidectomy was performed followed by radioactive (RAI) iodine therapy. Later, a total laparoscopic hysterectomy and right salpingo-oophorectomy were performed. There is no evidence of recurrent disease during the 26-months follow-up.Case 2A 46-year-old single female presented with left lower abdominal pain that had persisted for 2 months. Imaging revealed an 8 × 9 × 9.5 cm left ovarian mass. Laparoscopic left salpingo-oophorectomy was performed and histopathology showed mature cystic teratoma with small papillary thyroid cancer. CT showed no evidence of metastatic disease. Later, the patient had a total thyroidectomy followed by radioactive (RAI) iodine therapy. She was started on thyroxine and later had total abdominal hysterectomy and right salpingo-oophorectomy.ConclusionMSO is a very rare tumour. Preoperative diagnosis is very difficult because of the nonspecific symptoms and the lack of specific features in imaging studies. Also, there is no consensus on the optimal treatment of women with MSO. Our two cases add to the limited number of MSO cases.

Pediatric orbital lesions: non-neoplastic extraocular soft-tissue lesions.

Orbital pathologies can be broadly classified as ocular, extraocular soft-tissue (non-neoplastic and neoplastic), osseous, and traumatic. In this paper, we discuss the key imaging features and differential diagnoses of congenital and developmental lesions (dermoid cyst, dermolipoma), infective and inflammatory pathologies (pre-septal cellulitis, orbital cellulitis, optic neuritis, chalazion, thyroid ophthalmopathy, orbital pseudotumor), and non-neoplastic vascular anomalies (venous malformation, lymphatic malformation, carotid-cavernous fistula), emphasizing the key role of CT and MRI in the imaging work-up. In addition, we highlight the adjunctive role of ocular ultrasound in the diagnosis of dermoid cyst and chalazion, and discuss the primary role of ultrasound in the diagnosis of vascular malformations.