Epidermoid Cyst Research Articles

Ultrasound findings of endocrine mucin-producing sweat gland carcinoma mimicking epidermal cysts: A case series anddiagnostic challenges.

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is an uncommon, low-grade, malignant tumor that predominantly affects older patients and is often located around the eyelids. Diagnosing EMPSGC is challenging because of its clinical and imaging similarities to benign lesions such as epidermal cysts. This report presents two cases of EMPSGC with ultrasound features resembling benign cystic lesions that were initially considered in the differential diagnosis. For both cases, ultrasound imaging revealed hypoechoic masses with posterior acoustic enhancement and peritumoral vascularity, which are frequently associated with epidermal cysts. However, a histopathological analysis confirmed the diagnosis of EMPSGC demonstrating solid and papillary structures with mucin pools and neuroendocrine differentiation. These cases highlight the potential for misdiagnosis using preoperative imaging because ultrasound can obscure malignancy. Enhanced posterior echoes likely stem from mucin deposits within the tumor, thus underscoring the need for an early biopsy and histological analysis when atypical findings are observed. Additionally, Doppler ultrasound detected a peritumoral blood flow, which may suggest malignancy; however, benign lesions may exhibit similar vascularity. Further accumulation of cases is necessary to determine whether peritumoral vascularity is a distinguishing characteristic of EMPSGC. This report emphasizes the importance of recognizing EMPSGC's mimicry of benign lesions on ultrasound, particularly in cosmetically sensitive areas. An accurate diagnosis of EMPSGC requires imaging, histopathology, and immunohistochemical staining because misinterpretation may delay appropriate treatment and increase the risk of recurrence.

A Retrospective Single-Center Study in 20 Patients With Midline Nasal Masses: Which Site Has the Highest Risk of Recurrence?

Midline nasal masses are rare and challenging for surgeons. This study examined the site with the highest risk of recurrence following midline nasal mass excisions. Surgical outcomes were retrospectively reviewed following excision of midline nasal masses between 2010 and 2022 in the predominantly pediatric patient cohort. The primary outcome measure was the recurrence rate. Overall, 22 nasal masses were resected from 20 patients. Of these masses, 16 were nasal dermoid sinus cysts (NDSC), 2 were hamartomas, 1 was an epidermoid cyst, and 1 was a mature teratoma. Five of the nasal masses were classified as intracranial lesions, 11 were classified as intraosseous lesions, and 6 were classified as superficial lesions. The open rhinoplasty approach was chosen in 65% of the surgeries. For the intracranially extended lesions, a combined nasocranial approach was performed. Four revision surgeries were performed due to superficial recurrences at the nasal dorsum of lesions, that were primarily classified as intraosseous lesions. All recurrences had a superficial extension and were easily excised. Intraosseous NDSC have the highest risk of recurrence, but conversely, they also occur most frequently.

Intracranial Epidermoid Cyst in a Middle Aged Female: A Rare Case Report

Intracranial Epidermoid Cyst in a Middle Aged Female: A Rare Case Report

Giant epidermal cyst in the breast requiring reconstruction with the bilobed flap technique: case report

Epidermal cysts are one of the most common benign skin lesions, originating in the pilosebaceous unit, and are very common on the scalp, back, and trunk. They usually measure from millimeters to a few centimeters and require surgical treatment only depending on the patient's discomfort. Cases that mimic breast neoplasms are rare. Treatment consists of a minimal incision, with removal of the contents and their capsule, without major complications. We report here the case of a woman with an epidermal cyst in her left breast, which had grown progressively over the years, reaching 6 cm. Because of its size, location, and unfavorable relationship between tumor size and breast size, surgery using an oncoplastic breast remodeling technique was chosen, opting for the use of a bilobed flap to achieve a satisfactory cosmetic result, without loss of breast volume.

Imaging features of epidermoid cysts in intrapancreatic spleen: a single center study of 24 patients

ObjectiveThis study aims to investigate the imaging features of epidermoid cysts within intrapancreatic accessory spleen (ECIPAS) to benefit the differential diagnosis of pancreatic cystic lesions.MethodsWe retrospectively reviewed the clinical, radiological and pathological data of 24 patients with pathologically confirmed ECIPAS. All cases underwent abdominal contrast-enhanced computed tomography (CE-CT) scans, with 4 cases further undergoing magnetic resonance cholangiopancreatography (MRCP). The imaging features of the lesions were analyzed.ResultsThe majority of the patients were young to middle-aged with no apparent clinical symptoms. Over half of the masses exhibited circular, oval or unilocular architectures. On plain CT, the masses primarily displayed indistinct margins with an average diameter of 3.0 ± 1.1 cm. Nineteen lesions were situated in the pancreatic tail, 1 in the head, 1 in the head-body junction, and 3 in the body. In the arterial phases of enhanced CT scans, the lesions exhibited varying degrees of enhancement: slight enhancement (n = 11), significant enhancement (n = 5), and no discernible enhancement (n = 8) compared to pancreatic parenchyma. On MRCP scan, all four lesions showed hyperintense on T2-weighted imaging (T2WI).ConclusionECIPAS is a rare benign lesion, with nearly half exhibiting slightly uneven enhancement on contrast-enhanced CT scans. Usually, the solid-portion-enriched lesions show similar enhancement to that of the spleen, aiding in the precise preoperative diagnosis. ECIPAS can manifest in various locations within the pancreas, including the tail, head, and body. Patients may benefit from improved quality of life by avoiding unnecessary surgeries.

Cytologic Diagnosis of Squamous Cell Carcinoma Arising From a Recurrent Cerebellopontine Angle Epidermoid Cystin a 61-Year-Old Male.

Here, we report an exceptionally rare event of malignant transformation of an intracranial epidermoid cyst into squamous cell carcinoma (SCC), diagnosed through cerebrospinal fluid cytology. A 61-year-old male with a prior history of left retrosigmoid craniotomy and partial resection of a large cerebellopontine angle epidermoid tumor 13 years ago presented with acute mental status changes and weakness. Imaging revealed recurrent epidermoid cyst elements with associated obstructive hydrocephalus. The patient underwent ventriculoperitoneal shunt placement, and cerebrospinal fluid cytology revealed clusters of atypical epithelial cells. Further cytopathological and immunohistochemical (IHC) evaluation confirmed a diagnosis of SCC. Despite the initiation of chemotherapy and immunotherapy, the patient's condition deteriorated, and he passed away 2 months later. This case highlights the need for vigilance in monitoring patients with epidermoid cysts and that early detection through CSF cytology with confirmatory IHC provides a minimally invasive diagnostic pathway to guide rapid clinical decision-making.

Pitfalls in Ultrasound Diagnosis of Vascular Malformations: A Retrospective Review of 14 Nonvascular Tumors Treated as Vascular Malformations.

Background/Objectives: Vascular malformations form masses in subcutaneous and muscular tissues throughout the body and are occasionally misdiagnosed as subcutaneous nonvascular tumors. Understanding and differentiating their clinical and imaging features are crucial due to their different treatments and prognoses. This study aimed to report cases of nonvascular tumors that were initially misdiagnosed and treated as vascular malformations. Methods: In this retrospective observational study, we enrolled 14 (1.8%) patients with pathologically diagnosed nonvascular tumors from among 536 patients with 759 lesions of clinically diagnosed vascular malformations. Results: The average age at the initial visit was 41.9 years, with a male-to-female ratio of 3:11. Tumor locations included the lower limb in seven patients, the upper limb in five patients, and the trunk and head in one patient each. Ultrasound evaluation revealed 12 lesions of low-flow vascular malformations and two lesions of high-flow vascular malformations. These findings led to an initial diagnosis of venous or lymphatic malformations in 12 patients and arteriovenous malformations in two patients. Based on the clinical diagnosis, treatments administered before tumor resection included sclerotherapy in four patients and transcatheter arterial embolization in one patient. All patients underwent tumor resection. The final histopathological diagnoses included schwannoma in six patients, epidermal cyst and angiomyoma in two patients each, and other types of tumors in four patients. The average time from initial diagnosis to final histopathological diagnosis was 370 days. Conclusions: Multimodal diagnostic strategies, especially the use of ultrasound, enhance the differentiation between vascular malformations and nonvascular tumors.

Intra-Infundibular Epidermoid Cysts: A Distinct and Rare Entity.

Intra-Infundibular Epidermoid Cysts: A Distinct and Rare Entity.

Split cord malformations in adults.

Split cord malformations represent a small group among tethered cord syndromes. This paper presents the largest series of adult patients with this disorder reported to date. Neuroradiological features, clinical symptoms, surgical management and data on short- and long-term outcomes are analyzed. 94 adults (mean age 54.7 ± 15 years) presented with split cord malformations between 1991 and 2024 and were evaluated (follow-up of 64 ± 84 months). Radiological features, intraoperative findings, and neurological examinations before and after surgery were analyzed. Long-term outcomes were evaluated with Kaplan-Meier statistics. 35 patients presented with a split cord separated in two dural tubes (type I), 59 patients demonstrated a split cord type II with both hemicords in a single dural sac. 79 patients featured a low positioned conus and 10 patients a dermal sinus. In 31 patients (33%), the malformation was combined with a hamartoma, i.e. lipoma or dermoid, epidermoid, neurenteric or neuroepithelial cyst. The commonest clinical course consisted of radicular pain and slowly progressive neurological deficits. 51 patients underwent 59 operations with untethering the split cord, transection of the filum terminale, and hamartoma removal if applicable. There was no permanent surgical morbidity except for patients requiring a revision in split cords type I combined with a hamartoma. 61% considered their postoperative condition improved. Radicular pain responded best with only marginal neurological changes after surgery. Postoperative progression-free courses for 10 years corresponded to the complexity of the malformation: 83.3% experienced 10 year progression-free outcomes after first operation on any split cord without associated hamartoma. If a hamartoma accompanied the split cord, this figure dropped to 59.3%. The natural history of split cord malformations in adults is benign with slow neurological progression. Surgery should be reserved for symptomatic patients and provide untethering of all structures involved in the split as well as transection of the filum terminale. Associated dysraphic cysts require complete resection, while lipomas may be resected subtotally. The overall prognosis for patients requiring a revision is considerably reduced. Therefore, referral of these patients to appropriate centers is advisable.

Posterior Transpetrosal Approach for a Cerebellopontine Angle Epidermoid Cyst: Surgical Approach and Management of Vascular Injury: 2-Dimensional Operative Video.

Posterior Transpetrosal Approach for a Cerebellopontine Angle Epidermoid Cyst: Surgical Approach and Management of Vascular Injury: 2-Dimensional Operative Video.

A curious case of a solitary lower lip papule: A case report.

Solitary small painless lower lip lesions are common and can be of variable etiologies, giving rise to a wide number of clinical and histopathological differentials. From a clinico-pathological perspective, the diagnostic differentials may vary from vascular malformation, basal cell carcinoma, epidermal cyst, traumatic neuroma, neurofibroma, schwannoma, neurilemmoma, skin adnexal tumor, to other mucosal neuromas. Here we are reporting one such rare case masquerading as mucocele in a patient aged 37 years who reported first time at the ENT outpatient department. On biopsy and histopathological examination, a diagnosis of palisaded encapsulated neuroma (PEN), an uncommon benign nerve sheath tumor, was made.

Retraction Note: Personalizing neurosurgical strategies for epidermoid cysts with artificial intelligence.

Retraction Note: Personalizing neurosurgical strategies for epidermoid cysts with artificial intelligence.

Intracranial epidermoid cyst with malignant degeneration and leptomeningeal carcinomatosis: illustrative case.

Malignant transformation of epidermoid cysts (ECs) into squamous cell carcinoma (SCC) is extremely rare, with associated leptomeningeal carcinomatosis being much less likely. Malignant transformation of ECs has a poor prognosis with a median overall survival of 10 months following transformation. A 59-year-old male with a history of a subtotally resected posterior fossa EC presented with worsening symptoms 14 years following the initial subtotal resection. Imaging showed obstructive hydrocephalus and extensive leptomeningeal carcinomatosis. Laboratory workup confirmed malignant transformation to SCC. Nonmalignant recurrence of benign ECs is relatively common, often due to the complexity of complete resection and adherence to adjacent neurovascular structures. On the other hand, malignant degeneration of an EC is extremely rare. Any rapid change in symptoms, failure to recover following surgery, and new areas of irregular thickening and enhancement on imaging should prompt further evaluation for this process. https://thejns.org/doi/10.3171/CASE24738.

A rare finding of testicular epidermoid keratinized cyst in a prepubertal boy: case report and management standardization.

Testicular epidermoid cysts (TECs) are rare, benign lesions that can also mimic malignant testicular masses. Accurate preoperative diagnosis is essential for proper management. A 13-year-old male presented with a painless solid mass in the left testicle. Serum tumor markers were normal. Ultrasound, CEUS and MRI findings were consistent with TEC. Surgical enucleation of the mass was performed, after ruling out malignancy through intraoperative frozen section examination. Histopathology confirmed diagnosis of keratin-filled epidermoid cyst. At 3-month follow-up, the patient is well-being and scrotal US is normal. This case highlights the importance of considering epidermoid cysts in the differential diagnosis of testicular masses in young males. Ultrasound is the first-line imaging modality in the assessment of any testicular masses. Other imaging modalities such as CEUS, elastography and MRI can be helpful to distinguish between benign and malignant lesions. Testis-sparing surgery can be safely performed, after ruling out malignancy through intraoperative frozen-section analysis.

Real-Time, Quantitative, and Functional Monitoring of Abducens Nerve by Intraoperative Repetitive Direct Stimulation in Cerebellopontine Angle Epidermoid Cyst Surgery

Real-Time, Quantitative, and Functional Monitoring of Abducens Nerve by Intraoperative Repetitive Direct Stimulation in Cerebellopontine Angle Epidermoid Cyst Surgery

A Complicated Case of An Intracranial Epidermoid Cyst.

Intracranial vasospasm and ischaemic cerebrovascular accident (CVA) following surgical removal of intracranial tumours are rare.We report a case of ischaemic CVA and vasospasm following resection of an intracranial epidermoid cyst. Although the tumour was completely resected, vasospasm and ischaemic injury led to significant neurological deficits.Perioperative corticosteroids may be beneficial in reducing the incidence of vasospasm and ischaemic events, though their efficacy can vary.

Congenital spinal intramedullary epidermoid cyst

Spinal epidermoid cysts are rare benign tumors, accounting for <1% of all spinal tumors, with intramedullary cases being particularly uncommon. We present a rare case of a congenital intramedullary epidermoid cyst in a 12-year-old male, who presented with progressive bilateral lower limb weakness and gait disturbance over five months. Magnetic resonance imaging revealed a well-defined intramedullary lesion at the D6-D8 level, exhibiting hypointensity on T1-weighted images, hyperintensity on T2-weighted images, diffusion restriction on diffusion-weighted images, and peripheral rim-like enhancement on post-contrast imaging, suggestive of an epidermoid cyst. Surgical resection was performed, and histopathological analysis confirmed the presence of lamellated keratinous material, consistent with an epidermoid cyst. This case is notable for the absence of associated spinal dysraphism, making it a rare presentation. Imaging features, including characteristic signal patterns and diffusion restriction, aided in the diagnosis, distinguishing it from other intramedullary lesions such as arachnoid cysts, dermoid tumors, and neoplasms.

A clinicopathological study of eyelid tumors at a tertiary care hospital in South India

Eyelid tumors are common in people of all age groups representing more than 90% of ophthalmic tumors. Usually majority of these cases are either inflammatory or non-malignant tumors, however many malignancies can mimic a host of benign neoplasms and need differentiation before definitive therapy is started.To analyze clinical presentation, types of eyelid tumors, its histopathological correlation and management.A prospective study was conducted on patients presenting with eyelid tumors to our tertiary care hospital for duration of 2 years. Patients with eyelid tumors who fulfilled the inclusion criteria were diagnosed clinically and treated accordingly and all tumors were subjected to histopathological examination. The cases were analyzed for their age and sex distribution, incidence of malignant and benign tumors, tumor location and type. : In our study involving 50 patients, 29 were females and 21 were males, 47 cases were benign and 3 were malignant. Mean age of presentation of benign tumors was 44.81 years and malignant tumors was 67.25 years. Upper lid involvement was seen in 38 cases and lower lid in 12 cases. Intradermal nevus and epidermal cyst were the most common benign lesions and Sebaceous gland carcinoma was the most common malignant lesion. : Histopathological examination of all excised eyelid tumors is essential, as they may be malignant and require definitive treatment for better long-term management of the patient.

Commentary: Symptomatic Progression, Recurrence, and Long-Term Follow-Up of Patients With Intracranial Epidermoid Cysts.

Commentary: Symptomatic Progression, Recurrence, and Long-Term Follow-Up of Patients With Intracranial Epidermoid Cysts.

Clinical aspects of middle ear tympanokeratoma in dogs diagnosed through advanced imaging, otoendoscopy and histopathological evaluation

AbstractBackgroundCanine aural cholesteatoma (more appropriately named tympanokeratoma) is an epidermoid cyst whose aetiopathogenesis remains poorly recognised in veterinary medicine. There are a few reports published, possibly because it may be underdiagnosed.ObjectivesTo characterise the clinical aspects of dogs with tympanokeratoma, to describe the otoendoscopic, advanced imaging and histopathological findings of tympanokeratoma and to report the best approach to diagnose canine auricular tympanokeratoma in a retrospective study.Material and MethodsOf 890 dogs with suspected tympanokeratoma and otitis media, 100 animals underwent advanced imaging and otoendoscopy at radiology and dermatology reference centres in Brazil.ResultsMost affected dogs were male (71%) neutered (95%) with an average age of 6.8 years. Ninety‐one of the 100 affected dogs were brachycephalic. Otitis externa (OE; 81%) was the main non‐neurological manifestation observed. The main neurological clinical manifestations observed were: “head tilt” (66%), ataxia (31%) and nystagmus (25%). Advanced imaging findings could not propose a presumptive diagnosis of tympanokeratoma in 60 of 100 (60%) of the dogs. The absence of tympanic membrane and the presence of a dense pearly yellowish material resembling keratin in the tympanic bulla, after myringotomy, was the main otoendoscopic finding. The advanced imaging findings did not correlate with otoendoscopy and histopathological findings in more than half of the dogs.Conclusions and Clinical RelevanceTympanokeratoma should be suspected in brachycephalic dogs with OE and peripheral vestibular syndrome, and samples of keratinous material from the middle ear associated with histopathological results may be the best approach for the diagnosis.