Diagnosis Of Dermoid Cyst Research Articles

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.

Management of Dermoid Cysts in Pregnancy at a Tertiary Care Centre: A Retrospective Observational Study

Introduction: Ovarian masses are not uncommon in pregnancy. The increased use of Ultrasonography (USG) in recent years has led to the detection of asymptomatic ovarian masses in pregnant women. Dermoid cysts are the most common type of ovarian germ cell tumour in pregnancy. Most of them are asymptomatic and are incidental findings. However, a few can present with complications such as torsion and rupture. The diagnosis and management of dermoid cysts in pregnancy present a clinical dilemma. Aim: To evaluate the management and outcomes of antenatal patients diagnosed with dermoid cysts. Materials and Methods: A retrospective observational study was conducted in the Department of Obstetrics and Gynaecology at Christian Medical College, Vellore, Tamil Nadu, India, from January 2015 to January 2022. The study included 37 patients, and data regarding the diagnosis of dermoid cysts, their radiological and clinical characteristics, management, and pregnancy outcomes were collected from the electronic database. Descriptive statistics were used for reporting demographic and clinical characteristics. Categorical variables were presented as numbers with percentages, while continuous variables were presented as mean with Standard Deviation (SD) or median with Interquartile Range (IQR). Results: The dermoid cysts ranged in size from 2.2 cm to 30 cm, with a mean size of 7.28±4.51 cm. A total of 35 (95%) of them were incidentally detected. USG was the imaging modality used for diagnosis and follow-up. Only 30% (11/37) of the patients required surgical intervention during the antenatal period. Torsion was the indication for emergency surgical intervention in 46% (5/11) of cases. Laparoscopy was the preferred approach for surgical intervention in 91% (10/11) of patients. The remaining 70% (26/37) of patients were managed conservatively with serial USG, and no adverse outcomes were reported. Among the patients who underwent caesarean section for obstetric indications, 35% (13/37) also underwent surgical intervention for the dermoid cyst (either cystectomy or oophorectomy) during the same procedure. Conclusion: Antenatal patients diagnosed with dermoid cysts during pregnancy can be managed conservatively with serial USG, with a plan for surgical intervention if needed. In cases where surgical intervention is required, it can be safely performed as a laparoscopic procedure. In case of complications such as torsion, laparoscopy can be performed during pregnancy with appropriate precautionary measures.

Orbital and periorbital dermoid cysts: a retrospective analysis of 270 lesions

ABSTRACT Purpose To report the clinical characteristics and intraoperative findings of periorbital and orbital dermoid cysts and their relationship to location and rupture. Methods Retrospective review of 270 cases with orbital or periorbital dermoid cysts that presented over a period of 11 years. Patients were included if diagnosis of dermoid cyst was made by histopathologic analysis. Clinical characteristics and operative outcomes were recorded and analyzed with Chi-squared analyses or univariate regression. Multivariate binary logistic regression was performed to assess predictors of location and rupture. Results Dermoids frequently occurred unilaterally and were more frequently described as mobile (61.5%), followed by fixed (30.8%), and partially fixed (7.7%). Dermoid rigidity was most commonly described as firm (75.5%), followed by cystic, soft, and rubbery. The most common dermoid location was superotemporal (60.4%). On Chi-squared analysis, superotemporal lesions were less likely to have orbital extension than non-superotemporal lesions (OR 0.28, 95% CI: 0.11–0.70, p = .01), less likely to undergo CT (OR 0.16, 95% CI: 0.06–0.41, p < .01) or MRI (OR 0.23, 95% CI: 0.13–0.41, p < .01), more likely to be described as mobile (OR 2.91, 95% CI: 1.32–6.43, p = .01), and less likely to rupture intraoperatively (OR 0.28, 95% CI: 0.11–0.73, p = .01). No variables were associated with rupture in multivariate analysis. Conclusion Superotemporal dermoid cysts are common in the pediatric population, less likely to have orbital extension, undergo imaging, and have intraoperative rupture when compared to other locations in the orbit.

Mature Cystic Teratoma of the Ovary; Clinicopathological Evaluation of 143 Cases in our Series, 5 Years Experience

OBJECTIVE: Mature cystic teratoma, also known as a dermoid cyst, is the most common germ cell tumor of the ovary. In this retrospective study, it is aimed to evaluate clinicopathological findings of the patients who were operated on due to the preliminary diagnosis of dermoid cyst. STUDY DESIGN: Between May 2013 and May 2018, the findings of a total of 143 patients who were operated on with a preliminary diagnosis of dermoid cyst in our institution were analyzed retrospectively. In addition to demographic characteristics such as age, parity number and tumor size, lateralization, preoperative tumor markers, surgical procedure, presence of other pathological findings, and the rate of malignant transformation were analyzed. RESULTS: The median age of patients was 35.4 years and the ratio of nulliparous, primiparous, and multiparous patients was 46.9%, 25.2%, and 28%, respectively. The median tumor diameter was 6.7 cm, 50.3% of which were right-sided, 46.9% were left-sided and the remaining 2.8% were bilateral. Intraoperative torsion was found in 15 (10.5%) cases. The treatment consisted of 60.1% cystectomy by laparoscopy, 3.5% unilateral salpingo-oophorectomy by laparoscopy, 9.8% unilateral salpingo-oophorectomy by laparotomy, while the rate of 16.1% cases underwent hysterectomy with bilateral salpingo-oophorectomy by laparotomy, 10.5% of the cases, cysts were excised during cesarean section. As the final pathology report revealed, of 143 patients, immature teratoma was observed in five cases (3.5%), in one of them (0.7%) mixed germ cell tumor and in three of them (2.1%) borderline mucinous cancer, squamous cell carcinoma, and carcinoid tumor on mature cystic teratoma base were observed. CONCLUSION: Torsion is the most common complication with mature cystic teratoma. The size of the tumor is an important prognostic factor in terms of the malignant transformation of teratoma. Fertility sparing surgery with a minimally invasive surgical approach is available for fertility patients diagnosed with Mature cystic teratoma.

BASAL CELL ADENOMA: A RARE CASE WITH AN UNUSUAL PRESENTATION

Basal cell adenoma is a benign salivary gland neoplasm that mainly affects the parotid gland and rarely occurs in minor salivary glands. It is more common in older adults, with peak prevalence in the seventh decade of life, and clinically appears as a slowly growing mass. A 25-year-old white woman presented with a 6-mm submucosal nodule around the upper lip area. The lesion was asymptomatic and was covered with normal-looking mucosa. Based on the location, a clinical diagnosis of dermoid cyst was established, and an excisional biopsy was performed. Histopathologic examination showed a proliferation of cells with 2 phenotypes forming a tubular pattern within a fibrous stroma. Luminous cells exhibited oval and pale nuclei and eosinophilic cytoplasm, while basaloid cells contained pale or hyperchromatic nuclei and clear cytoplasm. A diagnosis of basal cell adenoma was made, and the patient was considered treated and is currently being followed up.

DERMOID CYST ENUCLEATION IN HEARING PAVILION

Introduction The dermoid cyst is a rare cystic malformation, classified as benign cystic teratoma. It is bordered by an epidermal-like epithelium, containing structures attached to its wall. These cysts originate from midline retained epithelial remains during the closure of the mandibular branchial arches and the hyoid bone. The prevalence in the head and neck region is low. They affect more young adults without a predilection for sex. Clinically, it presents as a swelling, of soft consistency upon palpation because it contains keratin remnants and sebaceous secretions inside. The lesion is usually about 2 cm in diameter. Surgical excision is the treatment of choice, with little risk of relapse. Objective To report the clinical case of a 16-year-old male patient who underwent cystic lesion excision in the ear region with a diagnosis of dermoid cyst. Methodology The methodology of the study was the search for articles related to the subject, organization in a brief literature review and its comparison with the case report that was described. Results A 16-year-old male patient, melanoderma, sought the Oral Maxillo Facial Surgery and Traumatology Service of the Federal University of Pernambuco of School Dentistry, reporting an increase in volume in the right postauricular region with approximately 3 years of evolution. On clinical examination, a well-circumscribed lesion without movement, soft to palpation and painless was observed. The patient underwent additional examinations and excisional biopsy under general anesthesia. The access started with an incision in the post-auricular region, followed by the myocutaneous tissue division until the lesion was visualized and soon after, the dissection of the adjacent tissues to the enucleation. Cauterization and hemostasis of the bleeding vessels were performed and suture to separate stitches with 5.0 mononylon thread. The surgical specimen was sent to the Anatomopathology Service of the Clinical Hospital of the Federal University of Pernambuco which provided the dermoid cyst report. Conclusion Excision biopsy is the protocol of choice for cystic lesions, since the treatment is its total enucleation, preferably encapsulated and its diagnosis is conclusive through histological analysis.

INTRACRANIAL DERMOID CYST: A CASE REPORT

Dermoid cyst of brain is a rare tumor arising due to embryogenic defect. It comprises only about 0.3% of intracranial tumors. A 18 year old female patient was admitted with complaints of seizures since last 6 months. The brain MRI suggested intra-axial dermoid cyst. The patient was operated &amp; histopathology report confirmed the diagnosis of dermoid cyst.

Orbital dermoid cyst presenting as chronic osteomyelitis

A dermoid cyst is a choristoma that arises from the displacement of ectoderm to a subcutaneous location along embryonic closure lines. Rarely dermoids have a deep intraorbital component that is connected to a superficial component through a defect in bone, also known as dumbbell dermoid. We report the case of a young boy who was misdiagnosed having chronic osteomyelitis of the zygoma, based on the clinical and radiological features. On surgical exploration he was found to have a dumbbell-shaped dermoid with a bony defect. Histopathological features were consistent with a diagnosis of dermoid cyst with chronic inflammation.

Dermoid cyst of pancreas: A rare entity

Dermoid cysts or mature cystic teratomas are mesenchymal neoplasms most commonly found in the ovaries, but which may occur in any location along the pathways of ectodermal cell migration. Pancreatic dermoid cysts are rare entity and preoperative diagnosis is difficult. A 27-year-old female presented with upper abdominal pain and vomiting of 1 week duration without jaundice, diarrhea, and fever. Ultrasound abdomen showed a 4 cm × 3 cm cyst in the head of pancreas with smooth walls. Magnetic resonance cholangiopancreatography showed large multilocular cystic lesion in pancreatic head region which displaces pancreas anteriorly and mildly superiorly. Endoscopic ultrasound-guided cyst fluid aspiration was done which revealed high cyst fluid amylase and carcinoembryonic antigen. At surgery, a pylorus-preserving pancreatoduodenectomy was done. Histopathologic examination revealed a rare diagnosis of dermoid cyst of pancreas. This case report highlights difficulty in preoperative diagnosis of cystic lesions of pancreas by imaging. Therefore, we want to highlight the literature in this rare entity.

Epidermoid Cyst of Tongue

Epidermoid cyst occurring within the tongue is rare. A 5 year old male child was brought to OPD with a tongue mass which was gradually increasing in size. There was associated difficulty in speech and mastication as the swelling increased in size. Intraoral examination revealed moderately tender,fluctuant and enlarged tongue. A diagnosis of dermoid cyst was made and the patient was booked for surgery. Excision of the cyst was done under general anaesthesia. Post-operative histopathology was done. The histopathological findings confirm the diagnosis of an epidermoid cyst, characterized by the presence of: (I) a cyst cavity lined by stratified squamous epithelium with keratinization on the surface; and (II) connective tissue with a mild inflammation. The proposed treatment was considered successful as the case was solved and there was no recurrence.

An Intragaleal Frontal Dermoid Cyst: A Location Never Reported

All dermoid cysts arising at the cranial vault had been reported as being located subgaleally, i.e. under the galea aponeurotica or epicranium. We are presenting a case that we believe to be the first case of an intragaleal dermoid cyst ever reported. An eighteen years old girl presented at our consultation for a midline frontal swelling evolving since 2 years. Neurological examination was normal. The Computed Tomography (CT) scan showed a round shaped heterogeneous mass at the vertex with no intracranial extension. The lesion was excised surgically. It appeared to be located intragaleally (within the epicranium) and composed of hairs and liquefied fat evocative of a dermoid cyst. The diagnosis of dermoid cyst was confirmed on histology. Postoperative outcome was excellent and the patient is symptom-free 16 months after surgery.

Epidermoid Cyst of Tongue: A Case Presentation

ABSTRACTEpidermoid cyst occurring within the tongue is rare. A 5-year- old male child was brought to outpatient department (OPD) with a tongue mass which was gradually increasing in size. There was associated difficulty in speech and mastication as the swelling increased in size. Intraoral examination revealed moderately tender, fluctuant and enlarged tongue. A diagnosis of dermoid cyst was made and the patient was booked for surgery. Excision of the cyst was done under general anesthesia. Postoperative histopathology was done. The histopathological findings confirm the diagnosis of an epidermoid cyst, characterized by the presence of: (i) a cyst cavity lined by stratified squamous epithelium with keratinization on the surface; and (ii) connective tissue with a mild inflammation. The proposed treatment was considered successful as the case was solved and there was no recurrence.How to cite this articleNaik C, Prusty N. Epidermoid Cyst of Tongue: A Case Presentation. Int J Otorhinolaryngol Clin 2014;6(3):134-136.

Periorbital dermoid cyst

Dermoid cysts are a developmental benign choristomas, which are congenital lesions representing normal tissue/s in an abnormal location. These consist of ectodermal and mesodermal elements, lined with epithelium and contain hair with other skin structures. Periorbital dermoid cyst is commonly located at lateral one third of the eyebrow. It is asymptomatic however school going child suffers from social stigma. So its surgical excision for cosmetic purpose becomes necessary. Excision also prevents bony remoulding and recurrent inflammatory responses due to leakage of cyst contents. In this article we are presenting a six years old male child having periorbital dermoid in lateral right eyebrow. The intact dermoid cyst was excised surgically and sent for histopathological examination, which confirmed the diagnosis of dermoid cyst. We highlight the merits of early surgical intervention, even in an asymptomatic periorbital dermoid cyst.

Isolated intramedullary cervical dermoid cyst

A 65-year-old male was admitted because of 2-month history of left arm weakness. Spinal MRI showed a cervical intramedullary lesion whose features suggested a dermoid cyst (Fig. 1 a, b). No spinal dysraphisms were evident. At operation (under neurophysiological monitoring), after a C2–C5 laminotomy, dural opening and myelotomy, the lesion appeared composed of two components: cranially the cyst was filled with caseous yellowish and pearly material which was removed; caudally the lesion presented calcified material which was only partially removed because it was very adherent to the surrounding neural tissue (Fig. 1 c, d). Post-operative course was characterized by worsening of left arm weakness and onset of moderate weakness of legs. Histological examination confirmed the presence of keratin debris and bone suggesting a diagnosis of dermoid cyst. Intramedullary dermoid cysts are extremely rare, accounting for less than 1 % of intramedullary spinal cord tumors [1]. They arise from cell remnants due to a failure of embryological process involved in the neural tube closure [1]. This process begins in the area of the neural tube destined to become the lower cervical cord and proceeds rostrally and caudally [1]. Hence these cysts are more often located in the lumbosacral spine. As the result of an embryological defect, they are usually associated with spinal dysraphism or dermal sinus tracts and thus are commonly seen during the first decade of life [1, 2]. Although some cases of isolated cervical dermoid cyst have previously been reported, most of them were published in pre-MRI era [1]. Dermoid cysts can be differentiated from intrinsic glial tumors of the cord on the basis of heterogeneity of the T1or T2-weighted signal, lack of contrast enhancement, and signal characteristics consistent with lipid content [1]. To our knowledge only two papers reported detailed description of MRI and intraoperative features of isolated cervical dermoid cysts [1, 2]. Both cases came to surgery because patients were symptomatic. Odgen et al. [1] report on a case of a 23-year-old man with a 3-month history of symptoms consistent with myelopathy, including hand weakness and paresthesias and an unsteady gait. Patankar et al. [2] describe the case of an 18-year-old female with a gradual appearance of spastic tetraparesis. In these two cases, at operation, the cyst wall was found to be very adherent to the adjacent neural tissue and only a subtotal resection was performed to avoid spinal cord damage [1, 2], as in our case. Nonetheless the morbidity remains high even with subtotal resection, with two patients (Pantakar et al. [2], and present case) worsened after the operation. Considering the benign nature of these congenital lesions and the significant risks related with the operation a conservative management should be considered for asymptomatic patients. F. Signorelli (&) N. Montano A. Scerrati B. Cioni F. Papacci Institute of Neurosurgery, Catholic University, Largo Agostino Gemelli 8, 00168 Rome, Italy e-mail: francesco.signorelli1984@gmail.com

Progressive visual loss following rupture of an intracranial dermoid cyst

A 51-year-old man with several months of headache and progressive visual decline was found to have bilateral optic disc pallor with significant impairment of visual acuity. Despite a thorough ophthalmologic evaluation, the cause of visual loss could not be elucidated. MRI of the brain revealed a lesion in the left anterior Sylvian fissure as well as disseminated foci of subarachnoid fat consistent with a diagnosis of a ruptured dermoid cyst. The decision for open surgical resection was chosen to minimize the risk of cyst re-rupture and further visual or neurologic decline. The diagnosis of dermoid cyst was confirmed at the time of surgery. Vasospasm-induced ischemia of the optic nerves, optic chiasm or bilateral optic tracts secondary to the inflammatory reaction following cyst rupture is the most likely mechanism of visual loss in this patient. To the authors’ knowledge, this report represents the first reported case of visual loss secondary to rupture of an intracranial dermoid cyst not related to mass effect of the tumor on the optic apparatus, visual pathways or visual cortex.

Dermoid cyst of the pancreas: A case report with literature review

Pancreatic dermoid cysts represent a rare entity with 35 cases described in the world literature, including the present one. Pre-operative diagnosis is difficult, with definitive diagnosis usually taking place intra-operatively. We report the case of a 63 year old male with a symptomatic, 6 cm cystic mass in the body of the pancreas. The pre-operative evaluation suggested a cystic neoplasm, but was indeterminate as to whether the lesion was benign or malignant. The diagnosis of dermoid cyst was made intra-operatively with frozen section. Although the diagnosis could not be made pre-operatively this retrospective report highlights the difficulty in evaluating cystic pancreatic lesions by imaging and summarizes the current body of knowledge on this rare entity.

Quantitative characterization of growth rate of an incidental deep dermoid cyst in a child using sequential magnetic resonance imaging

When orbital lesions are discovered incidentally, some have advocated observation given the slow-growing nature of deep dermoids; however, little has been published regarding the true growth potential of these tumors. We describe a case of an incidental deep orbital dermoid cyst in a 7.5-month-old girl with retinoblastoma. The cyst was monitored with five sequential magnetic resonance imaging studies of the orbit over 23 months with careful documentation of growth. The cyst was surgically removed without complication, and histopathology confirmed the diagnosis of dermoid cyst. This case represents the first published quantitative measurement of dermoid growth potential and highlights the need for close early monitoring in incidentally discovered cases.

Intra osseous dermoid cyst of mandible—A rare case report

The present article report a rare case of intraosseous dermoid cyst in mandible which clinically and radio-graphicaly presented as mandibular cyst. The diagnosis of dermoid cyst was confirmed histologically. A 20 year old patient was admitted to our Department with the complaint of swelling in left lower jaw with occasional pain. Radiographic examination revealed a radiolucent lesion extending from left 2nd molar to right premolar region. On surgical exploration the lesion was cystic in nature full of hair and keratinized tissues. The tissue was sent for the histopathological examination and macroscopic feature reveal numerous bits of soft tissue. The tissues were creamish brown in color, firm in consistency, with largest tissue measuring 2.5 × 1.5 × 0.5 cm in dimension. Few hair follicles were also evident within it. The histopathology reveal cyst lined by stratified squamous hyperor- thokeratinized epithelium supported by a fibrous connective tissue wall. The cystic epithelium is showing melanin pigmentation in the basal cell layer. Ab-undant onion skin keratin is seen within the cyst lumen. The epithelial lining as well as cyst wall shows numerous skin appendages such as lobules of seba-ceous glands. The underlying connective tissue shows mild chronic inflammatory infiltrate mainly composed of lymphocytes.

Epidermoid Cyst of the Tongue Causing Airway Obstruction

Epidermoid cyst occurring within the tongue is rare. The aim of this article is to discuss the management of an adult patient who presented with respiratory obstruction due to this congenital epidermoid cyst within the tongue. A 32-year-old male patient who was brought to the accident and emergency department of the University of Port Harcourt Teaching Hospital, Port-Harcourt, Rivers State, Nigeria was presented. He came with a history of difficulty in breathing as a result of a slow growing swelling of the tongue which started from birth. There was associated pain, difficulty in speech and mastication as the swelling increased in size. Detailed physical examination, sonographic imaging and histopathology were carried out. On examination, patient was acutely ill-looking, in severe respiratory distress, febrile, mildly pale and dehydrated but anicteric. Extra-oral examination revealed mildly protruded upper and lower dento-alveolar arch as well splaying and recession of the anterior and posterior teeth of the upper arch. Intra-oral examination revealed moderately tender, fluctuant and grossly enlarged tongue obstructing the oro- and nasopharyx. A diagnosis of dermoid cyst was made and the patient was booked for surgery after resuscitation. Excision of the cyst was done under general anaesthesia/naso-tracheal intubation by an intra-oral approach. Ultrasound was able to give a thorough assessment of the cystic nature of the swelling while post-operative histopathology was used to confirm the specific type of teratoma. The relationship of the cyst to the intrinsic and extrinsic muscles of the tongue and mylohyoid muscle was relevant to the surgical approach to the lesion.

Cisto dermoide lateral: relato de caso

The present study reports the case of a surgically treated lateral dermoid cyst, affecting the left submandibular space of a nine-year-old child, with a history of evolution of slow growth during approximately 1 year. The patient was admitted in the oral and maxillofacial surgery service of the Hospital Geral de Bonsucesso, complaining of esthetics in the absence of pain. The histopathologic exam revealed a cavity covered by orthokeratinized stratified epithelium, with abundant keratin in the cystic lumen and adnexal sebaceous glands and hair follicles in the capsule. Such characteristics were consistent with the diagnosis of dermoid cyst.