Diagnosis Of Epidermal Inclusion Cyst Research Articles

Cytomorphological spectrum of pilomatricoma - A series of 28 cases.

Pilomatricoma is a benign tumour that originates in the outer sheath of the hair follicle root. The clinical diagnosis of this rare entity is often missed, possibly due to a lack of awareness. Its characteristic cytomorphological features are sheets of ghost cells, basaloid cells, calcification and foreign body giant cell reaction. However, the above features may not all be present in all cases, rendering cytological diagnosis difficult. This retrospective study included all cases of pilomatricoma diagnosed on fine needle aspiration over a period of 4 years. The histopathological diagnosis was retrieved for the cases wherever possible. A detailed histopathological and cytological evaluation was performed for the various components-basaloid cells, ghost cells, calcified debris, foreign body giant cells, bare nuclei, neutrophils, and macrophages-and they were graded on a scale of 0 to 3+. The 28 cases included 8 female and 20 male patients with a mean age of 34.6 years. Most cases (22 cases; 78.6%) were located in the head and neck, with the scalp being the most common site. Twenty-five cases were cytologically diagnosed as pilomatricoma based on a variable admixture of the various components-nests of basaloid cells, ghost cells, foreign body giant cell reaction, calcified debris and viable squamous cells. However, in two cases which showed an absence of basaloid cells, a differential diagnosis of epidermal inclusion cyst was also included. Another case showed a predominance of basaloid cells with a paucity of ghost cells, so a differential diagnosis of adnexal tumour was also included. Among all the cytological parameters, sheets of ghost cells followed by nests of basaloid cells and foreign body giant cell reaction had the highest sensitivity in the cytological diagnosis of pilomatricoma. The presence of sheets of ghost cells is the most sensitive parameter for the cytological diagnosis of pilomatricoma. It is important that pilomatricoma should be considered in the differential diagnosis of subcutaneous masses, particularly in the head and neck region.

Epidermal Inclusion Cyst: A Rare Benign Breast Lesion

Epidermal inclusion cyst in the breast is an uncommon condition. It may be congenital, originating from hair follicles or occurring after trauma (breast reduction or breast cytology puncture) or consists of squamous metaplasia of the regular columnar epithelium within an ectatic ductus galactophorus. We report the case of a 22-year-old woman, with two pregnancies and with no particular pathological history, who presented with a 3 cm nodule of the right breast at the union of the upper quadrants, firm, mobile and painless. The skin, areola and nipple were unaffected. The axillary areas and the contralateral breast were unremarkable. The breast ultrasound showed a heterogeneous and well circumscribed hypoechoic mass classified as ACR3. Macroscopic examination revealed a unilocular cyst with a discretely thickened wall, abundant yellowish contents and measuring 2 cm on a long axis. Histologically, it was a cystic cavity whose wall was lined with a pseudo stratified keratinized squamous epithelium with a granular layer and whose lumen contained keratin lamellae. This cyst is surrounded by a more or less fibrous pallial tissue containing regular, sometimes dilated or even cystic milk ducts. The diagnosis of epidermal inclusion cyst of the breast on a background of fibrocystic mastopathy was thus concluded. The importance of this benign lesion lies in the differentiation between other non-neoplastic and neoplastic breast lesions.

Epidermal Inclusion Cyst in Submandibular Region

Epidermal inclusion cysts result from implantation and proliferation of epidermal elements in a space defined in the dermis, representing an unusual pathology in the submandibular region. A 20-year-old White female sought treatment at our oral and maxillofacial surgery service, complaining of swelling in the mandible. During the clinical examination, we observed a floating, asymptomatic nodular lesion. Histopathological analysis of the material obtained by incisional biopsy confirmed the diagnosis of epidermal inclusion cyst. Therefore, the cyst was enucleated by submandibular access. Conservative surgery is the therapy of choice for the treatment of epidermal inclusion cysts and has low rates of recurrence.

Quiste de inclusión epidérmica gigante de localización mamaria

Epidermoid cysts are located mainly in the subcutaneous tissue of the trunk and are usually small and asymptomatic. Localization in the breast parenchyma is rare and these cysts may become malignant. We report the case of a 23-year-old breastfeeding woman who presented with a lump protruding from her right breast that grew to more than 10cm. The diagnosis of epidermal inclusion cyst was confirmed by the pathological examination. Although distinguishing between an epidermoid cyst and a malignant tumor can sometimes be difficult, surgical excision is justified because these cysts can undergo malignant transformation. We discuss images of the breast and surgical specimen of this case and review the literature on the topic.

Precoccygeal epidermal inclusion cyst: ultrasound and MR imaging features.

In this case report, we are presenting a 33 year-old pregnant woman who suffered from pelvic and coccygeal pain. Her medical examination and laboratory tests were found within normal limits. In order to explain her pain, initially a pelvic ultrasound was performed which revealed a huge hypoechoic cystic mass in the precoccygeal-presacral region. She then underwent a pelvic magnetic resonance imaging (MRI) examination in order to better delineate the characteristics and extension of this huge mass. On these images the mass was hypointense on T1 weighted images and extremely hyperintense on T2 weighted images. We also performed a diffusion weighted sequence which exhibited high signal intensity for the mass. We thought that this finding could be suggestive of an epidermal inclusion cyst similar to that of a brain epidermoid cyst which shows bright signal intensity on diffusion weighted images. The patient was operated and the cystic mass removed from the precoccygeal region. Histopathological examination confirmed the diagnosis of epidermal inclusion cyst. This case report suggests that an epidermal inclusion cyst should be considered in the differential diagnosis of intractable pelvic and coccygeal pain. MRI can help to establish the correct diagnosis.

Giant Epidermal Inclusion Facial Cyst

Epidermal inclusion cyst is one of the most common subcutaneous tumors, and its size normally varies from 1 to 5 cm in diameter. Only few giant epidermal inclusion cysts have been reported in the literature, and giant epidermal cyst of the face has never been reported. An 83-year-old woman visited our hospital for a huge mass on the right side of her face extending to the temporal area, creating deformity of her right ear. The mass was 15 × 15 × 8 cm(3) with soft, cystic nature. It has developed since 20 years ago with no known etiology. Computed tomography scan was obtained for preoperative evaluation, which showed a 15 × 15 × 7-cm(3) huge, lobulated, and septated mass with no underlying bone or brain involvement. We performed complete excision sand biopsy. On histologic examination, the final diagnosis of epidermal inclusion cyst was made. Keratotic material was within the cyst, and the cystic wall was composed of lamellate keratin. Follow-up period was 10 months, and no signs of recurrence were seen. The patient was satisfied with the improvement of her facial appearance. We have observed a case of giant epidermal inclusion cyst of the face, which has never been reported, and present this case with a brief review of literature.

Congenital inclusion cyst of the subgaleal space: A case report

Subgaleal cysts are epidermal cysts located under the galea aponeurotica. They are rare lesions but are commoner among the children of African descent. To the authors knowledge, none has been described in Kano, Northwestern, Nigeria. We present the management of a 6 month old Nigerian boy with scalp swelling. The scalp swelling was noticed soon after birth and was progressively increasing in size. There was no preceding fever or trauma to the scalp and no associated pain. At six months, the child could sit without support and had attained adequate neck control. Examination revealed a swelling over the anterior fontanelle, measuring 3x2cm. The swelling was hemispherical, firm, fluctuant, and non-tender. It was not pulsatile. Its size did not increase on crying. Diagnosis was confirmed by plain x-ray film and transfontanelle sonography. Total excision of the mass was carried out under general anesthesia and histology confirmed the diagnosis of epidermal inclusion cyst. The child was discharged home in good condition. Awareness of this lesion will avoid misdiagnosis and inappropriate treatment.