Epidermoid Cyst Research Articles

304 Scar Assessment of Elliptical Versus Punch Biopsy Excision for Epidermoid and Pilar Cysts

304 Scar Assessment of Elliptical Versus Punch Biopsy Excision for Epidermoid and Pilar Cysts

Two Techniques to Avoid Cyst Spray During Excision.

Surgical removal of epidermoid cysts can result in "cyst spray," posing a nuisance and risk to the surgeon, staff, and patients. Employing simple techniques at the time of anesthesia administration may decrease exposure to cyst spray. We describe 2 methods that can help: (1) placing an antiseptic-soaked gauze pad over a premarked lesion, or (2) covering the cyst with a clear biohazard bag.

Intracranial poorly differentiated squamous cell carcinoma: case report and literature review

It is extremely uncommon to develop primary intracranial squamous cell carcinoma, which is typically brought on by the malignant transformation of epidermoid cysts or, less frequently, by other non-malignant epithelial cysts. We report a case of squamous cell carcinoma arise in the supra sellar region. She was operated via pterional approach. The patient was plaint of decrease in visual acuity. 6 months follow-up showed visual improvement. Intracranial squamous cell carcinoma is a rare disease whose clinical presentation, treatment, and prognosis are still unclear.

Ultrasound as a standalone tool for the management of pediatric calvarial dermoid cysts.

Calvarial dermoid and epidermoid cysts are benign lesions common in pediatric neurosurgery. Diagnosis is primarily clinical, with frequent but inconsistent use of imaging. Dermoids have been shown to possess distinct sonographic features, but ultrasound (US) remains underutilized in their management. The purpose of this study is to investigate the independent reliability of US in managing pediatric calvarial dermoids and distinguishing them from other calvarial lesions. A retrospective review of consecutive patients ≤ 21years of age with surgically resected calvarial masses between 2017-2024 was performed. Demographic, clinical, and imaging data were analyzed. Pearson chi-squared tests were used for comparison of categorical variables and a binomial linear model was generated controlling for age, lesion tenderness, growth, and suture location. Fifty-nine patients with 61 lesions (31 in females; median age 13months) were included. Dermoids were more common in younger patients (median age 12months), along suture lines, and were less likely to present with tenderness (p < 0.001) or rapid growth (p = 0.003). Ultrasound was used in 83% of cases and was the sole imaging modality in 33%. On multivariate analysis, suture location was a significant positive predictor of a dermoid diagnosis (OR = 8.08, 95% CI = 1.67-44.18), while rapid growth was a significant negative predictor (OR = 0.08, 95% CI = 0.003-0.80). Ultrasound presents a sensitive and reliable method for the evaluation of most pediatric calvarial lesions, especially dermoid cysts, and warrants being part of standard workup. With appropriate patient selection, US obviates the need for additional imaging in pediatric patients.

Cutaneous Leiomyoma of the Leg: A Case Report and Literature Review

Cutaneous leiomyoma is a rare benign smooth muscle tumor that can be mistaken for other nodular cutaneous lesions. We present the case of a 27-year-old female graduate who developed a swelling on her left leg over a period of 2 years. Initially painless, the lesion became painful a year later, with pain exacerbated by heat. The lump measured 1 x 1 x 1 cm, was tender, and not warm. Initially diagnosed clinically as an epidermal inclusion cyst, she underwent excision biopsy revealing leiomyoma upon histological examination. Subsequent to excision, all symptoms resolved completely, with no recurrence noted. Hence, it is crucial to consider cutaneous leiomyoma as a potential differential diagnosis for such cutaneous lesions.

Giant Cyst of Intra-Pancreatic Accessory Spleen Mimicking a Malignant Cystic Neoplasm of the Pancreas: a case report.

Epidermoid cyst in an intra-pancreatic accessory spleen (ECIPAS) is an exceedingly rare pancreatic lesion that is always mistakenly suspected of malignancy preoperatively. A 25-year-old male incidentally found a giant mass in the left upper abdomen neighboring the hilum of the spleen. The patient denied any obvious discomfort. Except for a slightly elevated carbohydrate antigen 19-9 (CA19-9, 43.5 U/ml), no abnormal laboratory test results were found. Contrast-enhanced computed tomography (CT), conventional ultrasound (US), and magnetic resonance imaging (MRI) were performed. The patient received a laparoscopic distal pancreatectomy. The final pathology showed ECIPAS. The postoperative course was uneventful and no signs of recurrence during 2 years of follow-up. For an incidental pancreatic cystic lesion (PCL), ECIPAS should be considered in the differential diagnosis. ECIPAS may mimic pancreatic cystadenoma. Imaging follow-up or surgical removal may be useful for the exclusion of malignant risks in ECIPAS.

A long‐standing exuberant epidermoid cyst in the parotid region in an older adult

A long‐standing exuberant epidermoid cyst in the parotid region in an older adult

Massively enlarged wandering spleen with ruptured epidermoid cyst

Massively enlarged wandering spleen with ruptured epidermoid cyst

Diffusion Analysis of Intracranial Epidermoid, Head and Neck Epidermal Inclusion Cyst, and Temporal Bone Cholesteatoma.

Intracranial epidermoid tumors, temporal bone cholesteatomas, and head and neck epidermoid inclusion cysts are typically slow-growing, benign conditions arising from ectodermal tissue. They exhibit increased signal on DWI. While much of the imaging literature describes these lesions as showing diffusion restriction, we aimed to investigate these qualitative signal intensities and interpretations of restricted diffusion with respect to normal brain structures. This study aimed to quantitatively evaluate the ADC values and histogram features of these lesions. This retrospective study included children with histologically confirmed diagnoses of intracranial epidermoid tumors, temporal bone cholesteatomas, or head and neck epidermoid inclusion cysts. Lesions were segmented, and voxelwise calculation of ADC values was performed along with histogram analysis. ADC calculations were validated with a second analysis software to ensure accuracy. Normal brain ROIs-including the cerebellum, white matter, and thalamus-served as normal comparators. Correlational analysis and Bland-Altman plots assessed agreement among software tools for ADC calculations. Differences in the distribution of values between the lesions and normal brain tissues were assessed using the Wilcoxon rank sum and Kruskal-Wallis tests. Forty-eight pathology-proved cases were included in this study. Among them, 13 (27.1%) patients had intracranial epidermoid tumors, 14 (29.2%) had head and neck epidermoid inclusion cysts, and 21 (43.7%) had temporal bone cholesteatomas. The mean age was 8.67 (SD, 5.30) years, and 27 (52.9%) were female. The intraclass correlation for absolute agreement for lesional ADC between the 2 software tools was 0.997 (95% CI, 0.995-0.998). The intracranial epidermoid tumor, head and neck epidermoid inclusion cyst, and temporal bone cholesteatoma median ADC values were not significantly different (973.7 versus 875.7 versus 933.2 ×10-6 mm2/s, P = .265). However, the ADCs of the 3 types of lesions were higher than those of 3 normal brain tissue types (933 versus 766, × 10-6 mm2/s, P < .0001). The ADC values of intracranial epidermoid tumors, temporal bone cholesteatomas, and head and neck epidermoid inclusion cysts are higher than those of normal brain regions. It is not accurate to simply classify these lesions as exhibiting restricted diffusion or reduced diffusivity without considering the tissue used for comparison. The observed hyperintensity on DWI compared with the brain is likely attributable to a relatively higher contribution of the T2 shinethrough effect.

Neurobrucellosis presenting as an infected epidermoid cyst in the cerebellum – A case report

Neurobrucellosis presenting as an infected epidermoid cyst in the cerebellum – A case report

Imaging the Male Breast: Gynecomastia, Male Breast Cancer, and Beyond.

The number of men undergoing breast imaging has increased in recent years, according to some reports. Most male breast concerns are related to benign causes, most commonly gynecomastia. The range of abnormalities typically encountered in the male breast is less broad than that encountered in women, given that lobule formation rarely occurs in men. Other benign causes of male breast palpable abnormalities with characteristic imaging findings include lipomas, sebaceous or epidermal inclusion cysts, and intramammary lymph nodes. Male breast cancer (MBC) is rare, representing up to 1% of breast cancer cases, but some data indicate that its incidence is increasing. MBC demonstrates some clinical features that overlap with those of gynecomastia, including a propensity for the subareolar breast. Men with breast cancer tend to present at a later stage than do women. MBC typically has similar imaging features to those of female breast cancer, often characterized by an irregular mass that may have associated calcifications. Occasionally, however, MBC has a benign-appearing imaging phenotype, with an oval shape and circumscribed margins, and therefore most solid breast masses in men require tissue diagnosis. Histopathologic evaluation may alternatively reveal other benign breast masses found in men, including papillomas, myofibroblastomas, and hemangiomas. Radiologists must be familiar with the breadth of male breast abnormalities to meet the rising challenge of caring for these patients. ©RSNA, 2024 Supplemental material is available for this article.

Intradural extramedullary epidermoid cyst: Case report

Spinal epidermoid cysts are benign tumors. They are most commonly extramedullary intradural tumors. Intramedullary localization is the exception. In this review, we report the case of a 45-year-old patient with a dorsal intradural extramedullary epidermoid cyst, revealed by dorsal spinal pain and right lower limb weakness, we discuss the clinical aspects, radiological features, and neurosurgical treatment.

Rare Location of Epidermal Inclusion Cyst in a Child - A Case Report

Epidermal inclusion cysts are benign lesions rarely found in the clitoris. This case report describes a 7-year-old girl presenting with a 2-year history of a painless clitoral swelling. Examination revealed a 1x2 cm firm, well-circumscribed cyst on the clitoral head. Fine needle aspiration (FNA) and magnetic resonance imaging (MRI) suggested an epidermal inclusion cyst. The cyst was excised surgically with preservation of clitoral anatomy. Histopathological examination confirmed the diagnosis. This report highlights the rarity of clitoral epidermal inclusion cysts and emphasizes the importance of considering this diagnosis in cases of clitoromegaly. A detailed history and examination can often differentiate this condition from other causes, avoiding unnecessary investigations. Surgical excision with clitoral preservation is the mainstay of treatment, aiming for optimal functional and cosmetic outcomes. A review of five published case reports of clitoral epidermal inclusion cysts is also included for comparison.

Isolated thoracic intradural extramedullary epidermoid cyst: A technical note.

Congenital, acquired, and iatrogenic spinal epidermoid cysts (EC) are very rare. A 62-year-old female patient presented with a 5-month history of progressive paraparesis leading to paraplegia secondary to a posterior compressive intradural extramedullary lesion at the T7 level. The patient underwent a laminectomy/durotomy for gross total tumor excision. Histopathology confirmed the lesion was an epidermoid cyst. Although her spasticity improved within 5 weeks, she only regained partial lower extremity motion (i.e., 3/5 motor function). Patients presenting with the acute/subacute onset of paraparesis secondary to spinal EC should undergo timely gross total cyst resections to optimize neurological outcomes.

P.084 Early malignant transformation of intracranial epidermoid cysts: a case report and systematic review

Background: Intracranial epidermoid cysts (IEC) are benign congenital intracranial lesions that rarely undergo malignant transformation. We report a case of IEC evolving into squamous cell carcinoma (SCC) 1-year post-resection. Further, we conducted a systematic review on cases of early malignant transformations of IECs. Methods: MEDLINE, EMBASE, and Scopus were searched from inception until December 2023 for studies reporting malignant transformations of IECs within 2 years of diagnosis. Results: A 48-year-old female underwent surgical resection of a cerebellopontine angle (CPA) IEC in May 2022. She re-presented in July 2023 with headaches, nausea, vomiting, right facial weakness, and rapid cyst progression. Repeat surgical resection revealed a high-grade SCC. Our systematic review identified 19 (10 females, 9 males) additional IEC cases undergoing malignant transformation within 2 years. The mean age at presentation was 57.6 years, most common location was CPA (n=13, 68.4%) and mean time between IEC to malignant transformation was 10.6 months. Eighteen (94.7%) cases transformed to SCC, of which 2 had leptomeningeal carcinomatosis, and 1 transformed to glioblastoma. Conclusions: While malignant transformations of IECs are rare, regular postoperative follow-up is crucial for early malignancy detection and treatment initiation. Further study is warranted to evaluate factors contributing to accelerated malignant progression of IECs.

Dermoid and Epidermoid Cysts of the Oral Cavity: Experience with 8 Cases

Dermoid and Epidermoid Cysts of the Oral Cavity: Experience with 8 Cases

Epidermoid Cyst of the Temporal and Infratemporal Region: A Rarity

Epidermoid Cyst of the Temporal and Infratemporal Region: A Rarity

Eruptive Epidermal Inclusion Cysts in a Renal Transplant Patient on Tacrolimus

Epidermal inclusion cysts are common cutaneous lesions that can develop anywhere on the body. While benign, these cysts can become inflamed and symptomatic. Symptomatic epidermal inclusion cysts can be treated with intralesional steroid injections or antibiotics, but surgical excision is often necessary for definitive treatment. We present a unique case of tacrolimus-induced eruptive epidermal inclusion cysts on the head and trunk of an adult male post-renal transplantation. Physicians should be familiar with this potential adverse effect, especially due to the difficulty of obtaining definitive treatment for a multitude of epidermal inclusion cysts.

Laparoscopic transabdominal approach for resection of presacral epidermoid cyst in an obese man: a case report

BackgroundComplete resection of presacral epidermoid cysts is recommended due to the potential for infection or malignancy. Transsacral and transabdominal approaches have been used to treat presacral tumors. However, there are no standard surgical approaches to resection. We present the case of a presacral epidermoid cyst in an obese male patient who underwent laparoscopic transabdominal resection.Case presentationA 44-year-old man was referred to our hospital for treatment of a cystic tumor on the pelvic floor. Contrast-enhanced computed tomography revealed a 45 × 40-mm tumor on the left ventral side of the rectum, right side of the ischial spine, dorsal side of the seminal vesicles, and in front of the 5th sacrum. Enhanced magnetic resonance imaging revealed a multilocular cystic tumor with high and low signal intensities on T2-weighted images. The tumor was diagnosed as an epidermoid cyst. We considered the transsacral or laparoscopic approach and decided to perform a laparoscopic-assisted transabdominal resection since the tumor was in front of away from the sacrum, and a transsacral approach would result in a larger scar due to poor visibility from the thickness of the buttocks. The entire tumor was safely resected under laparoscopic guidance, because the laparoscopic transabdominal approach can provide a good and magnified field of view even in a narrow pelvic cavity with small skin incisions, allowing safe resection of the pelvic organs, vessels, and nerves while observing the tumor contour.ConclusionsThe laparoscopic transabdominal approach is an effective method for treating presacral tumors in obese patients.

Umbilical keratinous cyst in a 7-year-old girl: A case report

Keratinous cysts, the most common kind of epidermal cysts, are filled with keratin originating from the epidermis, most often from the hair follicle. Keratinous cyst is one of the most common skin lesions and occurs most commonly in the face, head, trunk, extremities, and genitals. A 7-year-old girl reported to the pediatric surgery department with a painless, small tumor arising from her umbilicus. There was no history of trauma, and it has been slowly growing for the past many years. Clinical examination revealed a 3-cm-long skin tag with three small interconnected tumors from the umbilicus. It was soft, and the parts of the tumors looked like they contained whitish material inside. Her general and other systems, including the abdominal examinations, were within the normal limits. The tumor was resected through a sub-umbilical skin incision. She made an uninterrupted recovery. The excised specimens subjected to histology were reported as superficial keratinous cysts. Keratinous cysts are one of the most common benign skin lesions, but not the most common, at the umbilicus. Clinicians need to be aware of such pathology during the evaluation of the umbilical swellings and tumors, especially in children.