Traumatic Implantation Research Articles

8049 Beyond Metastasis: Parasitic Thyroid Tissue Mimicking Thyroid Cancer

Abstract Disclosure: M.S. Shah: None. S. Humayon: None. N.A. Mungo: None. This case study details a complex clinical scenario involving a patient with diaphoresis and a familial history of thyroid cancer. Initial suspicions of functionally active metastatic thyroid cancer led to a thyroidectomy and cervical lymph node dissection, only to reveal unexpected parasitic thyroid tissue. This case highlights the importance of meticulous evaluation and follow up similar presentations, shedding light on the rarity of this phenomenon.The patient, experiencing a year of diaphoresis unresponsive to estradiol therapy, underwent imaging revealing multiple thyroid nodules. A left superior nodule (TI-RADS 4) and a more concerning right mid-posterior nodule (TI-RADS 5) prompted fine needle aspiration (FNA). FNA of the right thyroid nodule exhibited Bethesda category III atypia, no molecular samples were taken at that time, while cervical lymph node FNA yielded nondiagnostic results.Subsequent ultrasound showed no interval change in the right thyroid nodule but raised concerns about increased solid components and decreased echogenicity in other nodules. Due to patient concerns of positive family history of thyroid cancer, the lymph node was biopsied. The result yielded a low cellular sample, but follicular thyroid tissue was present. The patient elected to undergo thyroidectomy as she did not want to continue monitoring. Pathology revealed parasitic thyroid tissue in the lymph node and nodular follicular thyroid disease, with no evidence of papillary thyroid carcinoma in the gland. Notably, the patient had no history of thyroid surgeries, ruling out traumatic rupture or implantation from a follicular adenoma. However, the possibility of follow-up metastatic follicular carcinoma cannot be entirely excluded on histologic grounds.Follow-up tests were recommended, encompassing mutational analysis, whole-body scans, and thyroglobulin (Tg) monitoring. Molecular analysis did not favor cancer. Tg levels remained at (18 ng/ml, n< 35ng/ml) of initial evaluation six weeks post surgery and repeat testing is pending. Ablative radioactive iodine therapy may be appropriate as resection of all parasitic thyroid tissue can prove difficult.This case emphasizes the diagnostic challenges posed by the rare occurrence of parasitic thyroid tissue, often mistaken for metastatic thyroid cancer. The findings contribute to our understanding of uncommon thyroid pathologies. The clinical implications of this case extend to the importance of heightened clinical suspicion in intricate endocrine cases. Presentation: 6/3/2024

Dynamics of Feline Sporotrichosis in Espírito Santo, Brazil: Impact of Urbanisation.

Sporotrichosis is a chronic infectious mycosis caused by traumatic implantation of Sporothrix spp., which poses a significant challenge to public health because of its zoonotic nature. It affects humans and other animals, particularly cats. This study investigated epidemiological trends and spatial distribution of feline sporotrichosis in Espírito Santo between 2017 and 2022. This study collected diagnostic data on sporotrichosis from the Veterinary Pathology Laboratory and Center for Infectious Diseases in Espírito Santo from 2017 to 2022. Statistical analyses were performed using STATA and spatial analyses were performed using ArcGIS software to create maps and identify hotspots. Kernel density estimation and directional mean statistics were applied to visualise the disease concentration and transmission trends. The results showed a significant increase in feline sporotrichosis cases in Espírito Santo from 2017 to 2022, with hotspots identified in urban and densely populated areas. Anchieta, Aracruz and Vila Velha reported the highest numbers of cases. Spatial analysis indicated a spread towards the central and northern coastal regions. This study highlights the growing threat of feline sporotrichosis in Espírito Santo, Brazil, particularly in densely populated urban areas. This underscores the urgent need for comprehensive public health strategies that address urbanisation, human-animal interactions and managing stray cat populations. Effective control measures and enhanced surveillance are crucial to mitigate the spread of this zoonotic disease. Importantly, this study provides valuable insights into the epidemiology of sporotrichosis in Brazil and offers a framework for other regions identified as emerging hotspots that face similar challenges.

Molluscum Pendulum of the Areola: One Case Report

Molluscum pendulum, is a benign asymptomatic fibroepithelial tumor that rarely appears on the areola-nipple plate. This tumor rarely exceeds 2 cm. The nipple is an unusual site for it. The soft fibroid may arise spontaneously or following traumatic implantation. We report the case of a patient with swelling at the nipple-areolar plate with a review of the literature.

Traumatic implantation keratitis caused by Schizophyllum commune in Central India

We present two cases with a history of trauma to the cornea and after a few days patients developed symptoms of corneal ulcers with one showing hypopyon as well. Due to strong suspicion of fungal keratitis both cases were treated with topical and intravenously voriconazole. Fungal culture showed white fluffy growth which was identified as Schizophyllum commune by conventional and molecular methods. In both cases surgical intervention was essential. Therapeutic keratoplasty was done in both cases but failed. Unfortunately, both patients lost vision in the affected eyes.

Sporothrix schenckii complex in felines: Analysis of clinical, mycological, environmental and epidemiological factors

Sporotrichosis is an infectious and chronic fungal disease caused by fungi belonging to the Sporothrix schenckii complex that affects humans and animals through traumatic implantation of the fungus in the skin. They are dimorphic, saprophytic and geophilic fungi that are widely distributed in nature, especially in soils rich in organic matter. The aim of this study was to understand the clinical, mycological, environmental and epidemiological aspects of the Sporothrix schenckii complex in felines. In order to meet the objectives of this research, a qualitative, descriptive and exploratory data survey was carried out through a bibliographic review based on works published in the last 23 years. Sporothrix spp. is considered to be a complex of at least six cryptic species, in other words, they have similar morphological characteristics but different genotypes. In cats, the incubation period is variable; it usually lasts 14 days. On penetrating the tissue, the micellar form transforms into yeast, which generates an inflammatory response and proliferation of the microorganism at the site, causing papular and nodular lesions which, in some cases, heal spontaneously. Therefore, it is clear that sporotrichosis is caused by dimorphic fungi of the Sporothrix schenkii complex. It is a zoonotic disease of great importance in the context of public health, since it is still a neglected disease and requires robust measures to control. As well as being the most seriously affected, felines are the main transmitters to humans and animals, making them a key point in controlling outbreaks of the disease.

Cerebral mucormycosis secondary to traumatic implantation

Cerebral mucormycosis secondary to traumatic implantation

Rare Presentation of Chromoblastomycosis Due to Multiple Simultaneous Inoculations: A Case Report

Chronic infectious, granulomatous and suppurative dermatosis, classified among the subcutaneous mycoses, prevalent in tropical and subtropical regions and caused by the traumatic implantation of dematiaceous fungal species, where the presence of muriform bodies is an expression of the causal agent in the grafted tissue, are characteristic of chromoblastomycosis. Considered the second implantation mycosis in the world, it manifests itself with slow and progressive growth lesions of exophytic and verrucous plaques and black dots on the surface. The disease is considered a neglected and occupational disease, which occurs mainly among agricultural workers, coconut and babassu harvesters, lumberjacks, and traders of agricultural products. It is important to highlight that people at risk of contracting chromoblastomycosis work in tropical countries, where the temperature can be above 40 °C in summer, and generally refuse to wear protective equipment during the day (shoes, gloves, clothes, etc.), although they know that this type of prophylactic measure can prevent different types of diseases. These vulnerable people often live in low-income countries and sometimes live far from medical services and, once infected, do not seek medical attention. We report below an exuberant and unusual case due to multiple simultaneous inoculations on the back after the patient suffered an accidental fall while working on his farm. The diagnosis was established by direct mycological examination, histopathological examination, culture, microculture, and MALDI-TOF MS analysis that identified the agent of the Fonsecaea pedrosoi.

Nasal and laryngeal sporotrichosis in an immunocompetent individual: a case report

BackgroundSporotrichosis is a subcutaneous mycosis caused by a dimorphic fungus, Sporothrix schenckii infection, that usually results from the traumatic implantation of the fungus into the skin and subcutaneous tissue. Disseminated cutaneous sporotrichosis is a rare entity that usually presents in the immunosuppressed individual. They are sometimes mimicking malignancy and tuberculosis. Here, a rare case of disseminated cutaneous sporotrichosis involving the larynx and nasal cavity in an immunocompetent patient is reported.Case presentationA 54-year-old healthy lady presented with hoarseness and globus sensation over the throat with prior history of multiple skin lesions over the face, limbs, and trunk. Examination revealed erythematous papular lesions over the face, limbs, and trunk. Nasoendoscopy showed sloughy mucosa over bilateral nasal cavities, nasopharynx, base of the tongue, arytenoids, and both vocal folds with bony hard mass at the left frontal recess opening. Overall imaging features were suggestive of generalized fungal infections. Multiple biopsies from multiple sites revealed Sporothrix schenckii infection. She had resolution of the lesion after being treated with intravenous Amphotericin B for a month, oral Voriconazole for another month then oral Itraconazole for 6 months.ConclusionDiagnosis of disseminated sporotrichosis can be tricky and difficult to diagnose as it can mimic other diagnoses. Education is paramount important in identifying the illness as it can be seen in immunocompetent individuals, although it is more common in the immunosuppressed individual.

Sporotrichosis in dogs: epidemiological and clinical-therapeutic profile and the emergence of itraconazole-resistant isolates.

Sporotrichosis is a neglected and emerging mycosis caused by the traumatic implantation of Sporothrix propagules into the (sub)cutaneous tissues of humans and animals. We evaluated canine sporotrichosis's clinical-therapeutic, epidemiological profile, and in vitro susceptibility of isolates to itraconazole. The variables were evaluated by a chi-square test. A total of 69 dogs were infected with Sporothrix spp., and the molecular identification revealed an overwhelming occurrence of S. brasiliensis as the etiological agent. The epidemiological profile was male (56.5%), adults (4.9±1.92 years old; 69.6%), and mongrels (53.6%). The clinical signs were 76.8%, ulcers, draining tracts, and nodules were predominant, mainly in the nasal region (82.2%). Dogs were diagnosed late with an evolution time of up to 3 months (34.8%). According to the prior therapeutic information, 52.2% received empirical therapy, 79.2% antibiotics, and had a 0.29 significantly greater chance of presenting lesion evolution time ˃ 3 months (P<.05; Odds Ratio [OR] 1/0.29). Additionally, 25 S. brasiliensis isolates recovered between 2006-2012 (n=15; Minimal inhibitory concentration (MIC): 0.06-2μg/ml) and 2013-2018 (n=10; MIC: 2→16μg/ml) were tested against itraconazole (ITZ). These findings highlighted the resistance to ITZ in clinical cases due to S. brasiliensis occurring after 2013, showing the temporal evolution of ITZ-resistance. We warn of the importance of accurate and early diagnosis in Sporothrix-affected areas, and we report the emergence of ITZ-resistant isolates in Southern Brazil.

P177 A Psittacine bite and subcutaneous Zygomycosis in immune competent: Case with therapeutic challenge

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM ObjectivesPrimary objective: To document a case of subcutaneous zygomycosis following a Psittacine bite in an immune-competent in India.Secondary objective: To follow-up the case till microbiological and clinical cure.MethodA case report entry prospectively carried out during 1.5 years of hospital visit of the patient with subcutaneous zygomycosis. This had ethical approval and patient consent obtained. A detailed account of case progression from date of first hospital admission to final cure was noted. A 56-year-old female from Vidisha in Madhya Pradesh India, apparently well 2 years back following a wild parrot bite on her back, causing an initial ulcer on infrascapular area gradually spreading bilaterally visited outpatient department of AIIMS, Bhopal. With prominent weight loss and non-healing ulcer; asymptomatic initially, ruptured spontaneously formed sinuses with exudate. Nodules and spontaneous rupture of nodule were mentioned. Provisional clinical differential diagnoses were nocardiosis, deep fungal infection, and Phagedenic ulcer. Tissue biopsy sent for microbiological and histopathological evaluation showed broad pauciseptate hyphae with right angle branching and bulging on direct microscopy suggesting subcutaneous zygomycosis. Histopathology H&E, and PAS showed similar morphology. A second sample sent was exudate from infrascapular region and showed broad pauciseptate hyphae with buildings on KOH mount. The patient was treated and discharged with some relief. Noncompliance to prescribed antifungal led to progression and horizontal spread forming plaque within months. A saturated solution of potassium iodide (SSKI) and itraconazole started. Lesions improved. The patient was again non-compliant and the lesions increased in size. The patient was reviewed again for the exacerbation and worsening. Around Day 10; SDA with chloramphenicol showed whitish growth with satellite colonies and LPCB showed broad quasi-septate hyaline hyphae, sporangia elongated, and beak with rounded zygospores suggesting Basidiobolus species. The patient received itraconazole, SSKI, and terbinafine. Species confirmation as Basidiobolus ranarum from PGIMER Chandigarh Mycology Reference center India was done.ResultsAfter 1.5 years, clinical improvement and final biopsy showed no growth and microscopy negative. The patient is on regular follow-up.ConclusionThis study highlights the traumatic implantation and zoonotic potential of fungal species. Clinical suspicion of fungal etiology and timely mycology laboratory diagnostic support is key to address such cases.

Atypical presence of Pseudallescheria boydii in a soft tissue infection in a patient from Southwest India

Pseudallescheria boydii is ubiquitous in nature and one of the most common causes of fungal mycetoma in temperate regions. Traumatic implantation of P. boydii into subcutaneous tissue or aspiration of contaminated water is some of the methods that can result in human infection (Hay, 1993). This fungus is infamous for its refractoriness toward therapy, predominantly seen in patients who are immunocompromised and resistance to several antifungal agents (Guarro et al., 2006; Tammer et al., 2011). We report an atypical case of P.

Dermoids of the Maxillofacial Region

Introduction: Dermoid and epidermoid cysts commonly termed as “Dermoids” are known to be developmental benign swellings that possibly occur as a result of traumatic implantation of epithelium or entrapment of epithelial remnants during embryonic fusion. The occurrence is rare (about 7%) in the head-and-neck region and they represent &lt;1.6% of all cysts of the oral cavity. Patients and Methods: A retrospective study was done on 12 histopathologically proven cases of epidermoid and dermoid cysts of the maxillofacial region that were treated in Shyam Shah Medical College, Rewa, Madhya Pradesh, India, from January 2013 to December 2019. The cases were evaluated for clinical presentation, demographic characteristics, and treatment performed. Results: Out of a total of 12 cases that were included in this study, 10 cases were diagnosed as epidermoid and 2 cases as true dermoid cysts. The mean age of occurrence was 31.66 ± 9.97 years. Male predominance was seen with a male-to-female ratio of 1.4:1. The floor of the mouth was the most commonly involved site in ten (83.34%) cases. Sublingual cysts were seen in five (41.67%) cases, combined sublingual–submandibular involvement in three (25%) cases, and midline floor of the mouth cyst in two (16.67%) cases. All the cases were treated by surgical enucleation, and no recurrence or malignant transformation was reported in any case at a minimum follow-up of 2 years. Conclusion: Based on the findings of this retrospective study, it is suggested that these lesions are very rare in the maxillofacial region and pose a diagnostic challenge. However, fine-needle aspiration cytology, ultrasound imaging, computerized tomography, and magnetic resonance imaging techniques can be relied upon for precise treatment planning. Surgical enucleation of these lesions is the preferred treatment modality.

Beyond Domestic Cats: Environmental Detection of Sporothrix brasiliensis DNA in a Hyperendemic Area of Sporotrichosis in Rio de Janeiro State, Brazil.

In Brazil, sporotrichosis has transitioned from a rural to urban disease, driven by a shift in the initiation of infection from the accidental inoculation of organic matter to the traumatic implantation of the fungus by cats. Since the emergence of zoonotic sporotrichosis caused by Sporothrix brasiliensis, investigations have largely ignored the environmental habitat of the pathogen due to its association with domestic cats. Therefore, we investigated 18 environmental samples collected from rural areas of two cities where zoonotic sporotrichosis is endemic, but where domestic cats are scarce. We utilized traditional culture methods, and samples were also examined with two molecular methods used for the clinical diagnosis of sporotrichosis: a nested-PCR targeting the ITS region and a species-specific PCR targeting the calmodulin gene. No Sporothrix colonies were identified by traditional culture methods. However, the nested-PCR and the species-specific PCR for S. brasiliensis were positive for 18 and 5 samples, respectively. Sequencing revealed that positive results with the nested-PCR were due to non-specific amplification of other Ophiostomatales DNA, rather than Sporothrix spp. Three of the five amplicons from the species-specific PCR were suitable for sequencing and confirmed the presence of S. brasiliensis DNA. Hence, we confirmed that S. brasiliensis, as with other Sporothrix species, has an environmental habitat. Our findings underscore the challenges of nested-PCR for Sporothrix environmental studies and highlight that sequencing must follow PCR protocols to definitively identify Sporothrix spp. in environmental samples.

Minimally traumatic implantation and bone regeneration: a systematic review

Introduction: Dental implant procedures have reached about one million dental implants per year worldwide. In this context, it is necessary to establish the state of the art of minimally traumatic procedures for dental implants, especially after bone grafting procedures and/or use of biomaterials for bone elevation. Objective: Conducted a systematic review of the main considerations for optimizing techniques for dental implants by proposing minimally invasive procedures, especially after bone recovery or elevation processes through the use of biomaterials such as FRP and Bio-Oss®. Methods: The survey was conducted from June 2021 to July 2021 and developed based on Scopus, PubMed, Science Direct, Scielo and Google Scholar, following the rules of Systematic Review-PRISMA. Study quality was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: Studies have shown that guided preoperative planning and dental implant-guided jaw reconstruction provide high success rates for implant and dental rehabilitation. Furthermore, the concept of using personalized implants with the help of 3D virtual treatment planning can greatly improve mandibular restoration and help to achieve good facial profile, esthetics and dental rehabilitation, avoiding complications with grafts in general.

Tatuaje por amalgama: Caso Clínico

The amalgam tattoo or focal argyrosis, is an iatrogenic lesion that follows the traumatic implantation of amalgam particles in soft tissue or the passive transfer by chronic friction of the mucosa against an amalgam restoration is characterized by the deposit of remains of restorative material composed of a mixture of silver, mercury, zinc, tin and copper in the connective tissue. Objective to present the clinical case of a patient with amalgam tattoo and the treatment that was carried out prior to his dental rehabilitation. Methods we did adiagnostic and excisional biopsy of the pigmentated lesion Result, as a result of the biopsy, we found that amalgam tattoo with a granulomatous reaction to a foreign body. Conclusion: By means of an excisional biopsy, the diagnosis of the lesion observed in the patient was verified, thus resulting in an amalgam tattoo with a granulomatous reaction to a foreign body

Old and New Insights into Sporothrix schenckii Complex Biology and Identification.

Sporothrix schenckii is a worldwide-distributed thermally dimorphic fungus, which usually causes a subacute to chronic infection through traumatic implantation or inoculation of its infectious propagules. The fungus encompasses a group of phylogenetically closely related species, thus named the S. schenckii complex, of which S. schenckii sensu stricto and S. brasiliensis are main causative species of sporotrichosis. Owing to a multifaceted molecular dynamic, the S. schenckii complex can switch between the mycelium and the yeast form. This characteristic along with a varying cell wall composition account for significant species-specific differences in the host range, virulence, and susceptibility to antifungal drugs. While culture remains the gold standard to diagnose sporotrichosis, polymerase chain reaction (PCR) or matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry-based methods have become an essential for accurate species identification in many clinical laboratories. If directly applied on tissue samples, molecular methods are helpful to improve both sensitivity of and time to the etiological diagnosis of sporotrichosis. This mini-review aims to put together the old and new knowledge on the S. schenckii complex biology and identification, with particular emphasis on the laboratory diagnosis-related aspects of disease.

Intracardiac Echocardiography-Guided Left Atrial Appendage Closure With a Novel Foam-Based Conformable Device: Safety and 1-Year Outcomes.

This is a first report of the safety and 1-year outcomes of left atrial appendage closure (LAAC) using a novel foam-based conformable device, guided by intracardiac echocardiography (ICE). Limitations of current transcatheter LAAC devices include the need for precise coaxial delivery into the left atrial appendage (LAA), potential for traumatic implantation, incomplete LAA seal, and device-related thrombus. The device (Conformal Left Atrial Appendage Seal, Conformal Medical Inc) is a self-expanding occluder consisting of a cylindrical nitinol endoskeleton with low-profile anchor barbs around the midpoint, covered with a porous foam cup. In a prospective single-center series, under conscious sedation, the device was delivered under fluoroscopic and ICE guidance. After positioning, a transesophageal echocardiography probe was placed to confirm ICE findings before device release. After closure, dual antiplatelet therapy was administered for 6months. Follow-up imaging was planned for 45days and 6 and 12months. A total of 15 patients (age 71.3 ± 10.8 years, 33% men, CHA2DS2-VASc 4.1 ± 1.7, HAS-BLED 3.4 ± 1.4) underwent LAAC, 100% successfully. There were no procedure/device-related complications requiring intervention. Asymptomatic pericardial effusion occurred in 2 patients. The 45-day, 6-month, and 12-month follow-up imaging in 11, 9, and 13 patients, respectively, revealed adequate LAA seal (leak≤5mm) in all patients; device-related thrombus was detected in 1 patient at 6months. Over 1-year follow-up, there were no ischemic strokes and 1minor bleed. Nonprocedure-/device-related death occurred in 2 patients. This first report indicates that LAAC with the conformable implant guided by ICE imaging is feasiblewith encouraging 1-year clinical outcomes. (The Conformal Prague Study; NCT04193826).

Epidermoid Cyst of the Ear Lobule in Adult

An epidermoid cyst is one of the most common benign cysts of the skin. The cyst is filled with keratin flakes and its wall is composed of keratinized, stratified, squamous epithelium. Epidermoid cysts can occur anywhere on the body, usually along the lines of embryonic fusion and mostly on the face, scalp, neck, chest, and upper back. Around 80% of the epidermoid cysts are seen in ovaries and testicles whereas, in the head and neck, they account for only about 7% and 1.6% of epidermoid cysts are reported in the oral cavity. The condition can be congenital or acquired. Congenital causes are rare and may be caused by the entrapment of ectodermal elements intradermally or subcutaneously during embryogenesis. Acquired causes of an epidermoid cyst may result from traumatic or iatrogenic implantation of epithelial cells into the dermal layer or from obstruction of a pilosebaceous unit in the hair follicle. Surgical excision completes the treatment.

METHODS OF POSITIONING CYLINDRICAL DENTAL IMPLANTS: A LITERATURE R

Advanced digital technologies and respective software offer dentistry much wider opportunities. Computed tomography, for one, is becoming more and more affordable and almost every dental tomograph has the necessary software installed for dental manipulation 3D planning. Dental implantation in Russia has seen significant development allowing dental implants to be installed even with scarce bone tissue. The purpose of this paper is to offer a review of various methods that can be employed to plan the installation of a dental implant as well as the preparation of surgical templates. Dentistry has always had a close connection with other fields of science and industry, attracting a large number of innovations. Here, we have collected data showing how the treatment procedure is changing through integration of computed diagnostics technologies (CT) and manufacturing (CAD/CAM) technologies. Consequently, we gain access to more efficient and less traumatic dental implantation planning systems, all this being based on accurate data and computer calculations that minimize any potentially negative technological or human factor.

Clinicopathological study of cutaneous adnexal cyst with some unusual presentation

Background: Cutaneous cysts are slow-growing benign intradermal or subcutaneous tumors that occur commonly in the hair-bearing areas of the body. Sometimes they occur in non-hair-bearing areas due to traumatic implantation of the epidermis. The present study was conducted to determine the prevalence of various cutaneous cysts in our hospital set up, to record an unusual presentation and clinico-histopathological correlation. Material and methods: This is a hospital-based retrospective analysis of cutaneous cysts conducted for 6 months. All skin biopsies diagnosed under the category of the cutaneous cyst were included in the study. Histopathology slides stained with Hematoxylin and eosin were analyzed. Results: A total of 185 cases of cutaneous cysts were included in the study. The most frequent cutaneous cyst was an epidermal cyst (75.13%) followed by a dermoid cyst (18.38%). Epidermal cysts occurred at unusual locations of the palm, lower extremity, and breast. Unusual locations of the dermoid cyst were the floor of the mouth, gluteal region, scalp, and back. Two cases of scrotal epidermal cysts were associated with idiopathic calcinosis of the scrotum. In one case each proliferating trichilemmal cyst and apocrine hidrocystoma occurred over the unusual location of the back while cysticercosis occurred at an unusual location of the scalp. Inflammatory changes were found in 27 cases (14.59%) of cutaneous cysts. An overall clinicopathological correlation was seen in 91.89% (170/185) cases of cutaneous cysts Conclusions: Unusual clinical presentation of cutaneous cysts can pose a diagnostic dilemma. Definitive diagnosis in such cases is possible by histopathological analysis.