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Safwan M, Godbole AA, Médéus AJR, García‐González OY, Sanker V, Prashanth PSSS, Dave T. Unusual giant plunging sublingual epidermoid cyst: A case report and review of literature. Clin Case Rep 2024; 12:e9067. [PMID: 38868117 PMCID: PMC11166552 DOI: 10.1002/ccr3.9067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 05/19/2024] [Accepted: 05/26/2024] [Indexed: 06/14/2024] Open
Abstract
Key Clinical Message When treating a painless or asymptomatic mass in the submental or floor of the mouth, sublingual epidermoid cyst should be considered. Despite its irregularity, preventing malignant transformation is essential for a successful outcome. Abstract Dermoid and epidermoid cysts are rarely found in the head and neck region. They account for less than 0.01% of all oral cavity cysts. This is a rare case of a sublingual epidermoid cyst of the oral cavity in a 25-year-old male. The patient presented with a painless sublingual swelling for a duration of 1 month. The clinical examination revealed a non-tender swelling in the sublingual region extending to the submental triangle. Magnetic resonance imaging confirmed a 6.2 × 7.7 × 3.2 cm cystic lesion in the sublingual space. Fine needle aspiration cytology confirmed dermoid cyst contents. Intra-oral surgical excision under general anesthesia was performed successfully. Histopathological analysis revealed that the cyst wall was lined by stratified squamous epithelium. The presence of a prominent granular layer and keratin flakes confirmed the diagnosis of an epidermoid cyst. Postoperative recovery was good, and no recurrence was observed during follow-up. This case emphasizes the infrequent and unusual presentation of a case of a giant plunging sublingual epidermoid cyst and promotes awareness and potential studies in the enhancement of patient care in this area.
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Affiliation(s)
- Mohamad Safwan
- Department of General and Minimal Access SurgeryKIMS health HospitalTrivandrumKeralaIndia
- Team ErevnitesTrivandrumIndia
| | - Aditya Amit Godbole
- Team ErevnitesTrivandrumIndia
- Bharati Vidyapeeth (Deemed to be University)Medical CollegePuneIndia
| | - Arens Jean Ricardo Médéus
- Team ErevnitesTrivandrumIndia
- Department of General SurgeryHospital of the State University of HaitiPort‐au‐PrinceHaiti
- Surgical Research and Global Education LabPort‐au‐PrinceHaiti
| | - Oxiris Yexalén García‐González
- Team ErevnitesTrivandrumIndia
- Monterrey Institute of Technology and Higher EducationMonterreyMexico
- Monterrey Institute of Technology and Higher EducationGuadalajaraMexico
| | - Vivek Sanker
- Team ErevnitesTrivandrumIndia
- Stanford UniversityStanfordCaliforniaUSA
| | | | - Tirth Dave
- Team ErevnitesTrivandrumIndia
- Bukovinian State Medical UniversityChernivtsiUkraine
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Bhuvan Chandra R, Pendem S, Selvarasu K, Krishnan M, M R M. Epidermoid Cyst Mimicking a Cystic Parotid Tumor: A Diagnostic Dilemma Deciphered Intraoperatively. Cureus 2024; 16:e54535. [PMID: 38516486 PMCID: PMC10956549 DOI: 10.7759/cureus.54535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/20/2024] [Indexed: 03/23/2024] Open
Abstract
Cystic lesions in the preauricular may have various histological origins, ranging from the skin to the acinar and non-acinar lesions from the parotid. Though advanced radiological investigations provide a good insight into the diagnosis of these lesions, diagnostic dilemmas may still prevail and warrant good clinical and surgical acumen to provide optimal treatment. The aim of the current report is to describe a case of an epidermoid cyst that mimicked a parotid cyst and discuss in detail the probable differential diagnosis and their management strategies.
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Affiliation(s)
- Raparthi Bhuvan Chandra
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Sneha Pendem
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Kathiravan Selvarasu
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Murugesan Krishnan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Muthusekhar M R
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Chaturvedi HT, Chaturvedi C, Thammaiah S, Damor PK. Epidermoid cyst of the midline neck in an 8-year-old girl: A case report. J Oral Maxillofac Pathol 2024; 28:158-160. [PMID: 38800440 PMCID: PMC11126264 DOI: 10.4103/jomfp.jomfp_69_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/15/2023] [Indexed: 05/29/2024] Open
Abstract
Epidermoid cysts (ECs) are usually small, benign, keratin-filled cysts, can be congenital or acquired and encountered anywhere in the body. EC and dermoid cyst constitute approximately 7% of all cysts in the head and neck region and tend to occur in areas of embryonic fusion. Neck masses are commonly present in children, and there is often a diagnostic dilemma clinically with common differential diagnoses of this region such as thyroglossal cyst, pre-tracheal lymph nodes, thyroid mass, EC and dermoid cyst. EC is mostly present in middle-aged males, and here, we are going to present an EC of the midline neck in an 8-year-old girl, which is not common.
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Affiliation(s)
| | | | - Smitha Thammaiah
- Department of Oral and Maxillofacial Pathology, VS Dental College and Hospital, Bengaluru, Karnataka, India
| | - Paresh Kumar Damor
- Department of Surgery, Gujarat Surgical Hospital, Vadodara, Gujarat, India
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Oh HJ, Eo MY, Sodnom-Ish B, Amponsah EK, Frimpong P, Myoung H, Kim SM. Craniofacial Epidermoid and Dermoid Cysts. J Craniofac Surg 2023; 34:2405-2409. [PMID: 37487139 PMCID: PMC10597412 DOI: 10.1097/scs.0000000000009561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Epidermoid and dermoid cysts are benign developmental anomalies that can form anywhere in the body. Despite the rarity of incidence in the head and neck, they can arise at a variety of craniofacial locations. The purpose of this study was to analyze the clinical features of epidermoid and dermoid cysts arising in the craniofacial region with a literature review. METHODS A retrospective study was designed, and clinical features and surgical considerations were investigated from a literature review. Cases of epidermoid cysts in the scalp, temporal area, glabellar area, mouth floor, and buccal mucosa were described. RESULTS Dermoid cysts in more lateral regions of the scalp are rarely associated with intracranial extension. Because temporal dermoid cysts have a high rate of intracranial extension, radiological evaluation of the lesions in the temporal area is imperative. Epidermoid cysts in the glabellar area are usually superficial. Consideration of the surgical approach for an epidermoid cyst of the mouth floor is important. Because epidermoid cysts in the buccal mucosa are extremely rare, differential diagnosis was emphasized. Epidermoid cysts in the scalp, in the temporal intradiploic area, on the glabellar area in the periorbital region, in the mouth floor, and in the buccal mucosa were surgically excised considering the depth and location. Ten cases of epidermoid cysts in the buccal mucosa were retrieved from the literature review. CONCLUSIONS Consideration of the anatomic locations of epidermoid and dermoid cysts in the craniofacial region might help facilitate accurate diagnosis and treatment.
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Affiliation(s)
- Hyun Jun Oh
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Mi Young Eo
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Buyanbileg Sodnom-Ish
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Emmanuel Kofi Amponsah
- Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana
| | - Paul Frimpong
- Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
- Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana
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Cunha JLS, Andrade ADO, Cavalcante IL, Barros CCDS, Sousa Neto SSD, Barros JMD, Leite LSDS, Félix FA, Turatti E, Carvalho FSR, Sousa SFD, Mendonça EFD, Anbinder AL, Pires FR, Alves PM, Nonaka CFW, Andrade BABD. Clinicopathologic analysis of oral dermoid and epidermoid cysts: a Brazilian multicenter study. Braz Oral Res 2023; 37:e107. [PMID: 38055524 DOI: 10.1590/1807-3107bor-2023.vol37.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/05/2023] [Indexed: 12/08/2023] Open
Abstract
Dermoid cysts (DCs) and epidermoid cysts (ECs) are uncommon developmental cysts affecting the oral cavity. This study aims to evaluate patients with oral DCs and ECs and their demographic and clinicopathologic features. A retrospective descriptive cross-sectional study was performed. A total of 105,077 biopsy records of oral and maxillofacial lesions from seven Brazilian oral pathology centers were analyzed. All cases diagnosed as oral DCs and ECs were reviewed, and clinical, demographic, and histopathological data were collected. The series comprised 32 DCs (31.4%) and 70 ECs (68.6%). Most of the DCs occurred on the floor of the mouth (n = 14; 45.2%) of women (n = 17; 53.1%) with a mean age of 34.6 ± 21.6 years. All DCs were lined partially or entirely by stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were observed in the fibrous capsule . Most of the ECs affected the labial mucosa (n = 20; 31.7%) of men (n = 39; 56.5%) with a mean age of 48.0±19.8 years. Microscopically, most ECs (n = 68; 97.1%) were lined entirely by stratified squamous epithelium. Two cysts (2.9%) showed areas of respiratory metaplasia. Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were also observed in the fibrous capsule. Conservative surgical excision was the treatment of choice in all cases. Oral DCs and ECs are uncommon and often clinically misdiagnosed lesions. Clinicians should consider DCs and ECs in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located on the floor of the mouth and labial mucosa.
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Affiliation(s)
- John Lennon Silva Cunha
- Universidade Estadual da Paraíba - UEPB, Department of Dentistry, Campina Grande, PB, Brazil
| | - Allany de Oliveira Andrade
- Universidade Estadual da Paraíba - UEPB, Department of Dentistry, Graduate Program in Dentistry, Campina Grande, PB, Brazil
| | - Israel Leal Cavalcante
- Universidade Federal do Rio de Janerio - UFRJ, School of Dentistry,Department of Oral Diagnosis and Pathology, Rio de Janeiro, RJ, Brazil
| | - Caio César da Silva Barros
- Universidade Federal do Rio Grande no Norte - UFRN, Department of Dentistry, Graduate Program in Dental Sciences, Natal, RN, Brazil
| | | | | | - Larissa Sandy da Silva Leite
- Universidade Estadual Paulista - Unesp, Institute of Biosciences, Department of Biosciences and Oral Diagnosis, São José dos Campos, SP, Brazil
| | - Fernanda Aragão Félix
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Eveline Turatti
- Universidade de Fortaleza - Unifor, Department of Dentistry, Fortaleza, CE, Brazil
| | | | - Sílvia Ferreira de Sousa
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | | | - Ana Lia Anbinder
- Universidade Estadual Paulista - Unesp, Institute of Biosciences, Department of Biosciences and Oral Diagnosis, São José dos Campos, SP, Brazil
| | - Fábio Ramoa Pires
- Universidade Estadual do Rio de Janeiro - Uerj, School of Dentistry, Department of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Pollianna Muniz Alves
- Universidade Estadual da Paraíba - UEPB, Department of Dentistry, Graduate Program in Dentistry, Campina Grande, PB, Brazil
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Asad Ullah M, Ahmed A, Hyder SMS, Javed K, Naeem MQ. An Unusual Case of Sublingual Epidermoid Cyst Mimicking Plunging Ranula. Cureus 2023; 15:e42874. [PMID: 37664298 PMCID: PMC10474325 DOI: 10.7759/cureus.42874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 09/05/2023] Open
Abstract
Epidermoid cyst in the oral cavity is uncommon. It is even more rare to see an epidermoid cyst in the sublingual region. We report the case of a 30-year-old male presenting with a swelling in the floor of the mouth extending into the submental and submandibular regions. The midline swelling was painless, soft, and dome-shaped. CT scan contrast revealed the site and extent of swelling. The complete surgical excision of the lesion was performed via a transcervical approach. Histopathology revealed cystic fibrocollagenous tissue covered by squamous epithelium containing some keratin flakes.
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Affiliation(s)
- Muhammad Asad Ullah
- Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Awais Ahmed
- Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | | | - Khalid Javed
- Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
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7
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Aihole JS. A rare case of anterior mid line neck cyst in a child. Int J Surg Case Rep 2023; 106:108298. [PMID: 37156201 DOI: 10.1016/j.ijscr.2023.108298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION Mid line neck swellings are common in paediatric as well as in adults. They can be of three categories; inflammatory, neoplastic, and congenital. CASE PRESENTATION A child with history of a nodular swelling over the anterior midline neck, its unusual diagnosis and its management has been discussed here. CLINICAL DISCUSSION Many of Non thyroidal lesions can mimic and present like thyroid nodules. Clinical examination with preoperative work-up will help to differentiate such lesions, in planning subsequent surgical intervention and hence avoiding iatrogenic damage to the thyroid gland. CONCLUSION Among the diverse and numerous mid line neck lesions, the clinical assessment can only aid in justifying the surgical procedure in these lesions.
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Dutta M, Kadambott S, Kar S, Arbaz M, Seth C. Sequestered, Iatrogenic Epidermoid Implantation Cysts Associated With Retroauricular (Wilde's) Incision. EAR, NOSE & THROAT JOURNAL 2022:1455613221146087. [PMID: 36511505 DOI: 10.1177/01455613221146087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
OBJECTIVE To report two patients with iatrogenic, epidermoid implantation cysts associated with the standard retroauricular (Wilde's) incision, to establish their etiology, to explore means to prevent them, and to ensure that this experience adds to the learning curve of the surgical training of the residents. METHODS Case series with the review of literature. RESULTS One of the two patients, who had an unremarkable follow-up period after cortical mastoidectomy and cartilage tympanoplasty performed three years back, presented with a retroauricular cystic swelling visible since two months. It was hyperintense on T2-weighted magnetic resonance imaging. A sequestered cystic mass was encountered at surgery in the subcutaneous plane in association with the retroauricular scar tissue from previous surgery. In the other patient, two similar cysts (one of them sequestered) were incidental findings at revision tympanomastoid surgery. Histopathology in both instances was consistent with epidermoid cyst. Given their subcuticular location and intimate association with a pre-existing surgical scar, they were considered to be of implantation in origin. This was a potential outcome of persistent inversion of one or both skin edges following simple interrupted suturing. The reason could be a faulty surgical technique, due to improper placement of the needle with respect to skin, inadequate or uneven tissue bite, a tight knot, or failure to manually evert the apposing edges at the point(s) of suspicion. CONCLUSIONS Sequestered epidermoid implantation cysts due to persistent inversion of sutured skin edges are unusual complications. The illustrations in this case series emphasize the need to adhere to the basic principles of surgical practice. They provide a caveat to the resident surgeons and the faculties who supervise them, that inadvertent and apparently innocuous misses, even at the elementary steps of surgery (like suturing), could lead to complications that are unwanted and potentially avoidable.
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Affiliation(s)
- Mainak Dutta
- Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata, India
| | - Sharafali Kadambott
- Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata, India
| | - Sutarthi Kar
- Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata, India
| | - Mirza Arbaz
- Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata, India
| | - Chandan Seth
- Department of Otorhinolaryngology and Head-Neck Surgery, M. R. Bangur Superspeciality Hospital, Kolkata, India
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Wang L, Zhang X, Zhao M, Wang Q. Assessment of epidermoid cyst with trigeminal neuralgia before neuroendoscopy: A high-resolution MR study based on 3D-FIESTA and MR angiography. Clin Imaging 2022; 91:9-13. [PMID: 35973272 DOI: 10.1016/j.clinimag.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/29/2022] [Accepted: 08/07/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the value of preoperative 3D-FIESTA and MR angiography (MRA) in endoscopic resection of epidermoid cysts presenting with trigeminal neuralgia (TN). METHODS 3D-FIESTA and MRA were performed before neuroendoscopy in 32 cases of epidermoid cysts with TN, and the tumors were grouped into types A, B, C, and D according to the relationship between the tumor and adjacent nerves and arteries (Hitoshi Kobata's classification). Evaluation of the neuroendoscopic resectability of different types of tumors, included gross total tumor removal (GTR), subtotal tumor removal (STR), and partial tumor removal (PTR). During the 5-year follow-up, symptoms were assessed based on facial pain relief using the Barrow Neurological Institute (BNI) score. RESULTS The coincidence rate between MRI classification of the tumor and the operation was 100%. Type B tumors were the most common (18/32, 56.3%). Type A tumors showed the highest resectability (9/9, 100%), followed by type B tumors (14/18, 77.8%). Moreover, microvascular decompression was performed in all 4 cases of type C and 1 case of type D tumors. During follow-up, 23 patients showed marked improvement in symptoms (15, 8 of BNI I or II), 8 cases showed partial improvement (BNI III), and only 1 case of type C tumor was associated with poor facial pain relief, which recurred 5 years later (BNI IV). CONCLUSIONS Preoperative high-resolution MR can accurately analyze the relationship between epidermoid cysts and adjacent nerves and arteries. It could act as a powerful tool in the evaluation of tumor resectability and the prognosis of surgery.
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Affiliation(s)
- Long Wang
- Department of Radiology, Jining No. 1 People's Hospital, Six Jiankang Road, Jining, China
| | - Xiaoming Zhang
- Department of Radiology, Qilu Hospital of Shandong University, No.107 Wenhuaxi Road, Jinan, China
| | - Meng Zhao
- Department of Radiology, Qilu Hospital of Shandong University, No.107 Wenhuaxi Road, Jinan, China
| | - Qian Wang
- Department of Radiology, Qilu Hospital of Shandong University, No.107 Wenhuaxi Road, Jinan, China.
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10
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Analysis of related factors between the occurrence of secondary epidermoid cyst of penis and circumcision. Sci Rep 2022; 12:13563. [PMID: 35945421 PMCID: PMC9360685 DOI: 10.1038/s41598-022-16876-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/18/2022] [Indexed: 11/14/2022] Open
Abstract
Secondary epidermoid cyst of the penis is a very rare epidermoid cyst that occurs in the penis. The purpose of this study was to investigate the relationship between the occurrence of secondary epidermoid cyst of penis and circumcision-related factors, and to provide possible reasonable and effective suggestions for circumcision. The data of all patients who visited the clinic for epidermoid cysts of the penis from September 2000 to September 2021 in Xiangya Hospital were collected. A retrospective study was carried out on whether the patients had been circumcised and the surgical method, anesthesia method, cyst location, surgical age, postoperative wound infection, whether they were phimosis patients, and the level of the surgeon. Among the 24 patients followed up, 95.8% had a history of circumcision, and only 4.2% had no history of circumcision, and the more traumatic surgical methods developed secondary epidermoid cyst of the penis after surgery the higher the probability. Injecting anesthesia at the base of the penis increases the chances of developing a secondary epidermoid cyst of the penis. Postoperative secondary epidermoid cyst of the penis were mainly located in the anterior segment and posterior segment, and the anterior segment had a higher proportion, followed by the posterior segment. Secondary epidermoid cyst of the penis occur mainly in adults. Postoperative wound infection accelerates the appearance of secondary epidermoid cyst of the penis. Patients with phimosis have an increased probability of developing secondary epidermoid cysts of the penis after surgery. The incidence of secondary epidermoid cysts and postoperative infection after manual circumcision by the attending physician was higher than that of the chief physician. Circumcision, injection of anesthesia at the base of the penis, ligation of the penis, and postoperative wound infection may be the etiologies and triggers of secondary epidermoid cysts of the penis. Adults and phimosis patients may be high-risk groups. Lower-level surgeons may increase the odds of postoperative secondary epidermoid cysts of the penis, and it is recommended that surgery be performed by a clinically-experienced, higher-level surgeon. The indications for circumcision should be strictly evaluated and the operation should be performed as soon as possible, and the less invasive surgical method and anesthesia method should be selected. Reduce irrelevant operations during surgery and avoid wound infection after surgery.
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11
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Eshraghi B, Shahsanaei A, Abounoori M, Pourazizi M. Atypical intraorbital dermoid and epidermoid cyst: A single institution cross-sectional retrospective study. Ann Med Surg (Lond) 2022; 79:103997. [PMID: 35860165 PMCID: PMC9289341 DOI: 10.1016/j.amsu.2022.103997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/10/2022] [Accepted: 06/12/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose Intraorbital epidermoid and dermoid cyst (DC) has been reported in the literature rarely. The current study evaluates clinicopathologic, radiologic, and management of intraorbital DC cases over ten years. Methods In this cross-sectional study, the medical records of patients with intraorbital DC treated at the academic referral center for ocular surgery were retrospectively reviewed. Data reviewed included the patient's demographic characteristics, clinical features, imaging, surgical technique, and pathology report. Results Nine patients with a rare presentation of intraorbital DC were reviewed within the study period in five presentations (five intraosseous, one intraconal, one dumbbell-shaped with a large part in anterior orbit, one juxta levator palpebral muscle, and one recurrent case with intracranial extension). They ranged from 8 to 53 years of age, with a median of 29 years, and five (55.6%) were female. Histopathological evaluation revealed two cysts were epidermoid. Conclusion The current study provides more clinical and radiologic manifestations of rare presentations of DC that highlight the importance of high clinical suspicion in the approach to atypical DC. The mean age of patients with intraorbital dermoid/epidermoid cyst was higher than periocular that usually present in early infancy. The most clinical signs of patients with intraorbital dermoid/epidermoid cyst were hypophthalmos, proptosis, lid puffiness, and ptosis. In addition to the atypical clinical presentation of intraorbital dermoid/epidermoid cyst, the radiological investigation is doubted potentially and can be caused mixed missed cases. So histopathological evaluation is essential for confirmation of the diagnosis. It may be difficult or impossible to excise a complete intraosseous dermoid/epidermoid cyst. In such cases, evacuating cyst contents allowed for easier dissection around the lesion. In addition, burring the bone is necessary in cases where there is an intimate connection of the cyst wall to the bone.
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12
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Neuberger I, Tutman JJ, White CJ, Mirsky DM. Isolated lesions of the suprasternal notch in pediatric patients. Pediatr Radiol 2022; 52:1266-1271. [PMID: 35237855 DOI: 10.1007/s00247-022-05314-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/04/2022] [Accepted: 02/03/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Palpable masses of the head and neck are a common indication for imaging in the pediatric population. Midline lesions of the infrahyoid neck, particularly lesions isolated to the suprasternal notch, are not well studied. OBJECTIVE To delineate the histopathological and imaging spectrum of masses that occur within and isolated to the suprasternal notch. MATERIALS AND METHODS A retrospective study was performed to identify patients with an isolated lesion of the suprasternal notch that had available pathological diagnoses. Available imaging was reviewed and characterized by fellowship-trained pediatric radiologists and compared by descriptive statistics to the final pathological diagnoses. RESULTS Eighteen masses isolated to the suprasternal notch with available pathological diagnoses were identified. Of these, congenital epithelial inclusion cysts were diagnosed in 14 patients (77.8%) with dermoid cysts comprising 11 of those (61.1%) and epidermoid cysts accounting for 3 (16.7%). The most common imaging appearance was a cystic or pseudosolid appearance without vascularity. CONCLUSIONS Isolated resected lesions of the suprasternal notch in pediatric patients are most frequently dermoid/epidermoid cysts, with a differential diagnosis including other less common entities.
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Affiliation(s)
- Ilana Neuberger
- Department of Radiology, Children's Hospital Colorado, University of Colorado, 13123 E. 16th Ave., Box 125, Aurora, CO, 80045, USA.
| | - Jeffrey J Tutman
- Department of Radiology, Children's Hospital Colorado, University of Colorado, 13123 E. 16th Ave., Box 125, Aurora, CO, 80045, USA
| | - Christina J White
- Department of Radiology, Children's Hospital Colorado, University of Colorado, 13123 E. 16th Ave., Box 125, Aurora, CO, 80045, USA
| | - David M Mirsky
- Department of Radiology, Children's Hospital Colorado, University of Colorado, 13123 E. 16th Ave., Box 125, Aurora, CO, 80045, USA
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Iwai T, Minamiyama S, Mitsudo K. A solitary, asymptomatic cystic lesion in the submandibular region. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 139:305-307. [PMID: 34955447 DOI: 10.1016/j.anorl.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/03/2022]
Affiliation(s)
- T Iwai
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Japan.
| | - S Minamiyama
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Japan
| | - K Mitsudo
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Japan
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Bhasker N. Review of Head and Neck Masses in the Indian Population Based on Prevalence and Etiology With an Emphasis on Primary Diagnostic Modalities. Cureus 2021; 13:e16249. [PMID: 34381644 PMCID: PMC8351261 DOI: 10.7759/cureus.16249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 12/25/2022] Open
Abstract
Head and neck masses are classified as sebaceous cysts (epidermoid cysts), cervical lymphadenopathy, benign lipomas, lymph nodes, thyroid swellings, or tuberculosis lymphadenitis that may be painful or painless, adherent or fluctuant. In spite of this, they have distinct prognoses and pathological features. The anatomical location of the swelling and other demographic manifestations of the patient provide valuable information about the cause and type of swelling. Computed tomography (CT), magnetic resonance imaging, positron emission tomography-CT, and ultrasonography are the gold standard imaging methods for the head and neck examination. These methods are used according to the region considered for the study. Fine-needle aspiration cytology of lymph nodes is known to be effective, simple, and sometimes the only tool for the diagnosis of lymph node malignancies. This review highlights the epidemiological aspect of head and neck masses in the Indian population.
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Affiliation(s)
- Nilam Bhasker
- Pathology, Employees' State Insurance Corporation Hospital, Lucknow, IND
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Abstract
ABSTRACT Epidermoid and dermoid cysts (ECs and DCs) are congenital anomalies occurring in areas of embryonic fusion. Their incidence in the head and neck region is low and ranges from 1.6% to 7%. The aim of this study is to report on the clinical characteristics, treatment, and outcome of 22 patients from a single-institution experience. A retrospective analysis of patients treated for ECs and DCs of the head and neck over a 12-year period was performed. The present study included 22 patients (male/female ratio 1:1). The mean age of presentation was 11.68 years. The lesions were distributed in the orbital regions in 7 (31.82%) patients, auricular regions in 6 (27.27%), neck regions in 5 (22.73%), floor of the mouth in 3 (13.64%), and nose in 1 (4.55%). Complete surgical excision was performed as a definitive treatment method in 21 patients (95.45%). The mean size of the excised lesions was 21.36 mm at the widest length (range: 10-70 mm). On the basis of histopathological examinations, 15 (71.43%) lesions were classified as ECs and 6 (28.57%) as DCs. Post-operative complications were noted in 3 (14.29%) patients--2 (9.52%) with recurrences and 1 (4.76%) with hypertrophic scarring. All of these patients were successfully cured after a second surgery. The ECs and DCs of the head and neck present an interesting diagnostic and therapeutic challenge. Successful management depends on a thorough knowledge of their clinical and radiological features.
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Gandhi K, van der Woerd BD, Graham ME, Barton M, Strychowsky JE. Cervicofacial Actinomycosis in the Pediatric Population: Presentation and Management. Ann Otol Rhinol Laryngol 2021; 131:312-321. [PMID: 34060325 PMCID: PMC8814968 DOI: 10.1177/00034894211021273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Infection caused by Actinomyces species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess formation, sinus drainage and can be complicated by osteomyelitis. METHODS Presented are 2 pediatric cases of secondary actinomycosis in the context of congenital lesions: 1 patient with a previously excised preauricular sinus and another with a persistent sublingual mass. A comprehensive literature search was conducted for reported cases of pediatric actinomycosis in the cervicofacial region. RESULTS Both cases presented were successfully treated with a combination of complete surgical excision of the lesions and prolonged antibiotic therapy. Thirty-four pediatric cases of cervicofacial actinomycosis are reviewed, 2 presented herein, and 32 from the published literature. There was equal gender distribution and the median age was 7.5 years. The most common site for infection was the submandibular area. Four (12%) of cases arose in pre-existing congenital lesions. Most patients were treated with penicillin-based antibiotics for a median duration of 6 months following surgical excision or debridement. CONCLUSIONS Actinomycosis is a rare infection of the cervicofacial region; secondary infections arising from congenital lesions of the head and neck are even more rare. A previously excised pre-auricular sinus and a sublingual dermoid cyst are not previously reported sites of infection. Actinomycosis should be suspected in chronically draining sinuses of the head and neck region and confirmed through anaerobic culture. Osteomyelitis is a potential complication and magnetic resonance (MR) imaging is warranted. Long-term antibiotic therapy with a penicillin-based antibiotic and surgical excision should be considered.
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Affiliation(s)
- Karan Gandhi
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Benjamin D van der Woerd
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
| | - M Elise Graham
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.,Department of Pediatrics, Western University, London, ON, Canada
| | - Michelle Barton
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Pediatrics, Western University, London, ON, Canada
| | - Julie E Strychowsky
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.,Department of Pediatrics, Western University, London, ON, Canada
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Misch E, Kashiwazaki R, Lovell MA, Herrmann BW. Pediatric sublingual dermoid and epidermoid cysts: A 20-year institutional review. Int J Pediatr Otorhinolaryngol 2020; 138:110265. [PMID: 32795730 DOI: 10.1016/j.ijporl.2020.110265] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Pediatric cystic sublingual masses often present a diagnostic dilemma for practitioners. Though uncommon, dermoid or epidermoid cysts can present in the sublingual space at any age and are often misdiagnosed as an inflammatory pseudocyst (ranula) or lymphatic malformation. Imaging may not always identify the underlying etiology, requiring physicians to maintain a high index of suspicion for these relatively rare oral cysts. OBJECTIVES To describe the presentation and treatment of sublingual dermoid and epidermoid cysts presenting to a tertiary children's hospital over 20 years. METHODS A retrospective review of all pathology specimens identified as dermoid or epidermoid cysts within the sublingual space from 1999 to 2019. Patient charts were then reviewed for relevant clinical, imaging, and operative data. RESULTS Twelve pediatric patients were identified (8 female, 4 male) with a mean age of 7.2 years (SD 5.6). Eighty six percent (6/7) of dermoid cysts were found in female patients, while 60% (3/5) of epidermoid cysts were in male patients. Multiple dermoid and epidermoid cysts were each found in one patient (8%). Two epidermoid cysts presented in the neonatal period. Preoperative diagnosis included nondiagnostic "cystic mass" (33%), ranula (25%), lymphatic malformation (LM) (17%), and dermoid/epidermoid cyst (17%). Two thirds of patients (8/12) underwent imaging, with all receiving either MRI or CT. Although MRI was the most likely to suggest the possibility of a dermoid/epidermoid cyst (2/4), ranula was the most common primary radiographic diagnosis (5/8). One patient underwent sclerotherapy for presumed LM one year prior to surgical excision of the cyst. Eleven patients (92%) underwent intraoral excision, one (8.3%) underwent a combined intraoral/extraoral approach. CONCLUSIONS To our knowledge, this review represents the largest case series of pediatric sublingual dermoid and epidermoid cysts to date. This series contained higher levels of epidermoid cysts and female patients than previously reported in the literature. Identifying more dermoid cysts in females and epidermoid cysts in males is also a new finding. MRI was superior to CT and US regarding the presence of a dermoid/epidermoid cyst. Frequently misdiagnosed, it is important to consider these relatively rare pathologies when treating children presenting with sublingual masses in order to avoid delayed and/or inappropriate treatment.
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Affiliation(s)
- Emily Misch
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ryota Kashiwazaki
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA; Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Mark A Lovell
- Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA; Department of Pathology University of Colorado School of Medicine, Aurora, CO, USA
| | - Brian W Herrmann
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA; Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA.
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Kim CS, Na YC, Yun CS, Huh WH, Lim BR. Epidermoid cyst: A single-center review of 432 cases. Arch Craniofac Surg 2020; 21:171-175. [PMID: 32630989 PMCID: PMC7349137 DOI: 10.7181/acfs.2020.00248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/19/2020] [Indexed: 11/12/2022] Open
Abstract
Background Epidermoid cysts are benign tumors derived from the infundibular portion of hair follicles and thus have a flattened surface epithelium and keratohyaline granules. They can occur at any age but are most frequently reported in adults, and more often occur in men than women. Most epidermoid cyst operations are performed for cosmetic purposes, or to relieve inflammation. The definitive treatment is complete excision or destruction of the cyst. The aim of this study was to improve understanding of epidermoid cysts. Methods We analyzed 432 cases of epidermoid cyst in 398 patients that underwent complete excision and biopsy between April 2001 and March 2020, according to patient age, patient gender, and lesion location. Results From all epidermoid cyst excisions performed, 17.6% were for patients in their 40s and 50s, 16.8% for those in their 20s, 16.1% for those in their 30s, 14.6% for those aged 60 or older, 5.0% for teenagers, and 0.5% for those under 10 years. Cases of epidermoid cysts occurred at a men-to-women ratio of about 3:2, with 59.5% of cases in men and 40.5% in women. By lesion location, 65.0% of cases were on the face, 10.9% on the trunk, 7.9% on the scalp, 7.9% on the neck, 4.3% on lower extremities, 3.9% on upper extremities, and 0.2% on genitalia. On the face, 20.8% of cases were on the cheek, 12.7% on the periauricular area, 10.9% on the periorbital area, 6.0% on the frontal area, 5.6% on the mental area, 3.7% on the perioral area, 2.8% on the nasal area, and 2.5% on the temporal area. Conclusion The proportion of women with epidermoid cysts was higher in our study than in previous studies. Moreover, the results showed that surgery has been on the rise in recent years, with facial surgery being the most common.
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Affiliation(s)
- Choon Soo Kim
- Department of Plastic and Reconstructive Surgery, Wonkwang University Hospital, Iksan, Korea
| | - Young Cheon Na
- Department of Plastic and Reconstructive Surgery, Wonkwang University Hospital, Iksan, Korea
| | - Chi Sun Yun
- Department of Plastic and Reconstructive Surgery, Wonkwang University Hospital, Iksan, Korea
| | - Woo Hoe Huh
- Department of Plastic and Reconstructive Surgery, Wonkwang University Hospital, Iksan, Korea
| | - Bo Ra Lim
- Department of Dermatology, Wonkwang University Hospital, Iksan, Korea
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Liu NN, Zhang XY, Tang YY, Wang ZM. Two sequential surgeries in infant with multiple floor of the mouth dermoid cysts: A case report. World J Clin Cases 2020; 8:2885-2892. [PMID: 32742999 PMCID: PMC7360698 DOI: 10.12998/wjcc.v8.i13.2885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/23/2020] [Accepted: 06/03/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Multiple intraoral dermoid cysts of large magnitude generally appear in the second or third decade of life. They are rare in infants and are usually solitary. In this case, a large mass was identified in utero during prenatal exams.
CASE SUMMARY We introduce a rare case on multiple dermoid cysts in the floor of the mouth of an infant who underwent two surgeries for this. Preoperative magnetic resonance imaging confirmed a large well-circumscribed cystic lesion that originated at the former midline region in the floor of the mouth in which a suspicious lesion of minute size was likely compressed by the bulkier mass and overlooked. Therefore, the infant underwent two surgeries by an intraoral approach within 9 mo. At 5 mo after the second operation, a routine follow-up ultrasound showed evidence of an additional cyst. No further surgery was planned because the tumor had no immediate effect.
CONCLUSION This report demonstrates the importance of carefully analyzing preoperative imaging to avoid multiple operations for a seemingly isolated oral cyst.
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Affiliation(s)
- Nan-Nan Liu
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Xin-Yue Zhang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Yan-Yan Tang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Zhi-Ming Wang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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Abstract
OBJECTIVE The postauricular region (PR) is an anatomic area that has been neglected until now, due to the fact that the significant cosmetic changes and features of this region are often overlooked. There are limited and inconsistent data about postauricular masses in the literature and the definition of the PR and its borders remain unclear. The aim of the present study was to define the PR and evaluate benign and malignant masses that may arise in the PR. METHODS Fifty-two patients were enrolled in the study. The patients were evaluated retrospectively in terms of demographic data, including age, gender, operative method, lesion side and size, diagnostic tools, and histopathologic diagnosis of the masses. RESULTS The masses were categorized into 4 groups according to the etiology; neoplastic (n: 15, 28.8%), inflammatory (n: 13, 25%), congenital (n: 22, 42.3%) and traumatic (n: 2, 3.8%). Of the neoplastic masses, 6 (11.5%) were nonmelanoma skin cancer, comprising 4 (7.6%) basal cell carcinomas and 2 (3.8%) squamous cell carcinomas. A total of 9 (17.3%) neoplastic masses were benign, comprising 3 (5.7%) lipomas, 3 (5.7%) temporal bone osteomas, 2 (3.8%) nevi, and 1 (1.9%) plexiform neurofibroma. Of the 13 (25%) inflammatory masses, 12 (23%) were lymph nodes and 1 (1.9%) was pilonidal sinus. There were 22 (42.3%) congenital masses comprising 15 (28.8%) epidermal cysts, 4 (7.6%) dermoid cysts, and 3 (5.7%) hemangiomas. The 2 (3.8%) patients with traumatic lesion were both keloid patients. CONCLUSION The PR does not attract attention from the cosmetic point of view but many benign and malignant masses can be found in this region. Any masses detected in this area should be treated to prevent further growth.
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UĞUR KILINÇ AN. PALATİN TONSİL'İN EPİDERMOİD KİSTİ: RASTLANTISAL NADİR BİR DURUM VE LİTERATÜRÜN GÖZDEN GEÇİRİLMESİ. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2020. [DOI: 10.17517/ksutfd.728417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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22
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Middle ear congenital cholesteatoma: systematic review, meta-analysis and insights on its pathogenesis. Eur Arch Otorhinolaryngol 2020; 277:987-998. [PMID: 31955213 DOI: 10.1007/s00405-020-05792-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 01/07/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Congenital cholesteatoma (CC) presents as a white pearl-like lesion behind a normal tympanic membrane (TM), without a history of otorrhea, infection, perforation or previous otologic surgery. Several recent studies provided new data improving this pathology characterization. The aim of this paper is to expand the knowledge about CC and to provide new insights on its pathogenesis. METHODS The study consisted of two main research parts: (1) systematic review and meta-analysis; (2) medical literature review englobing anatomy, histology, embryology and congenital pathology of the ear. RESULTS The search strategy identified a total of 636 papers. Seventy retrospective studies were included. A total of 1497 cases were studied and the mean age was 6.58 years, with a male-female ratio of 3:1, 34% were asymptomatic, 26% had hearing loss and 2% had facial dysfunction/paralysis. The overall estimate for antero-superior quadrant involvement was 0.70 [95% confident interval (CI) 0.64-0.76], in the postero-superior quadrant was 0.60 (95% CI 0.52-0.69), in the antero-inferior quadrant was 0.32 (95% CI 0.23-0.41), in the postero-inferior quadrant was 0.38 (95% CI 0.29-0.47), in the attic was 0.53 (95% CI 0.43-0.63) and in the mastoid was 0.33 (95% CI 0.26-0.41). More advanced Potsic stages were present in older patients. The most likely inclusion place seems to be between the pars flaccida and the upper quadrants of the pars tensa. CONCLUSIONS During the last decades, a substantial improvement in CC diagnosis and management had been achieved. The presented mechanism seems to explain most of middle ear CC.
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Epidermoid Cyst at a Rare Location in a Child. J Craniofac Surg 2020; 31:596-597. [PMID: 31917709 DOI: 10.1097/scs.0000000000006122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lengane NI, Ouattara S, Zaghre N, Some MJM, Ouedraogo T, Ouedraogo BP. [Voluminous epidermoid cyst compressing the upper cervical spinal cord: about a clinical case]. Pan Afr Med J 2019; 34:169. [PMID: 32153709 PMCID: PMC7046120 DOI: 10.11604/pamj.2019.34.169.19925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/02/2019] [Indexed: 11/15/2022] Open
Abstract
Le kyste épidermoïde est une tumeur bénigne d'origine embryonnaire. Il est lié à une localisation anormale du tissu ectodermique. La localisation cervicale est rare. Il peut poser des difficultés diagnostiques, surtout dans les formes volumineuses et compressives. Nous rapportons un cas de volumineux kyste épidermoïde du cou avec des signes de compression des voies aérodigestives supérieures. Le patient a bénéficié d'une cervicotomie avec exérèse de la masse. L'examen anatomopathologique de la pièce opératoire retrouvait un kyste épidermique.
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Affiliation(s)
- Nogognan Ignace Lengane
- Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-faciale, Centre Hospitalier Universitaire Régional de Ouahigouya, Ouahigouya, Burkina Faso
| | - Souleymane Ouattara
- Service de Laboratoire, Section Anatomo-pathologie, Centre Hospitalier Universitaire de Tingandogo, Tingandogo, Burkina Faso
| | - Noé Zaghre
- Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-faciale, Centre Hospitalier Universitaire de Tingandogo, Tingandogo, Burkina Faso
| | | | - Therese Ouedraogo
- Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-faciale, Centre Hospitalier Universitaire de Tingandogo, Tingandogo, Burkina Faso
| | - Bertin Priva Ouedraogo
- Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-faciale, Centre Hospitalier Universitaire de Tingandogo, Tingandogo, Burkina Faso
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Bouatay R, Jellali S, Abdejelil N, Koubaa J. Epidermoid cyst of the tonsil: a rare finding. Pan Afr Med J 2019; 34:4. [PMID: 31762873 PMCID: PMC6850734 DOI: 10.11604/pamj.2019.34.4.18193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 07/15/2019] [Indexed: 11/13/2022] Open
Abstract
Epidermoid cysts (ECs) are benign lesions that can be encountered throughout the body, but with a low incidence in the head and neck (1.6 to 7%). In oral cavity, the most common affected site is floor of the mouth, but tonsillar location remains extremely rare (less than 0.01%). Here we present an epidermoid cyst of the right palatine tonsil which was incidentally detected in a patient who consulted for a chronic headache.
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Affiliation(s)
- Rachida Bouatay
- Department of Otorhinolaryngology and Head and Neck Surgery at "Fattouma Bourguiba" Hospital of Monastir, Tunisia
| | - Sondos Jellali
- Department of Otorhinolaryngology and Head and Neck Surgery at "Fattouma Bourguiba" Hospital of Monastir, Tunisia
| | - Nouha Abdejelil
- Pathology Department at "Fattouma Bourguiba" Hospital of Monastir, Tunisia
| | - Jamel Koubaa
- Department of Otorhinolaryngology and Head and Neck Surgery at "Fattouma Bourguiba" Hospital of Monastir, Tunisia
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You E, Bokhari R, Sirhan D. Split-Pons Syndrome by Epidermoid Cyst: A Case Report and Review of the Literature. World Neurosurg 2019; 131:275-280.e1. [DOI: 10.1016/j.wneu.2019.07.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 10/26/2022]
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Abstract
Epidermoid cysts are slow-growing, painless masses that elevate the skin and often have a central punctum that represents the plugged orifice of the pilosebaceous follicle. On ultrasound, they have a round to oval structure, well-circumscribed, avascular mass located in subcutaneous tissue along with phenomena of dorsal acoustic amplification and lateral shadowing. On MRI, they have slightly hypointense signal intensity on T1-weighted and intermediate to high signal on T2-weighted. Restricted diffusion is typical of epidermoid cysts. These signs are useful in the differentiation of epidermal cysts from neoplastic lesions. They need early treatment as they can cause cosmetic and functional impairment.
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Solivetti FM, Desiderio F, Elia F, Guerrisi A, Cota C, Morrone A. Sonographic appearance of sebaceous cysts. Our experience and a review of the literature. Int J Dermatol 2019; 58:1353-1359. [PMID: 31209860 DOI: 10.1111/ijd.14515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 02/07/2019] [Accepted: 05/13/2019] [Indexed: 11/26/2022]
Abstract
Sebaceous cysts are benign enveloped nodules resulting from an obstruction of a hair follicle. Although they are very common, differential diagnosis is not obvious and may include many diseases. Ultrasound examination with high frequency probes, in the hands of a skilled operator, is the gold standard for noninvasive evaluation of these diseases. The aim of our study was to describe sonographic patterns found in our experience with high frequency probes. We decided to reevaluate the sonographic appearance of the last 100 patients with sebaceous cysts that were under our observation through conducting a retrospective study. All lesions were examined by a skilled radiologist with an Esaote MyLab 70 XVG ultrasound unit and a dedicated 18 MHz linear probe, sometimes supplemented by 20 MHz. In these skin lesions, we evaluated morphology, size, vascularity, and especially the visibility of skin pores, a characteristic of sebaceous cysts. We found 118 lesions that were mostly located on the trunk. In the majority of cases, the skin lesions had an oval-shaped morphology - 114 (96.6%) - and were hypoechoic in appearance -108 (91.5%). In 60 (50.8%) cases, the skin lesions showed a homogeneous appearance, known as "pseudotestis". The average ultrasound examines with very high frequency probes allowed to evidence skin pores. Our retrospective study on higher frequency probes confirms the data in literature regarding the diagnosis of sebaceous cysts, demonstrating the high incidence and clinical significance of evidence of the so-called epidermal punctum.
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Affiliation(s)
| | - Flora Desiderio
- Radiodiagnostic Service San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Fulvia Elia
- Radiodiagnostic Service San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Antonino Guerrisi
- Radiodiagnostic Service San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Carlo Cota
- Dermatopathology Laboratory San Gallicano, Dermatological Institute IRCCS, Rome, Italy
| | - Aldo Morrone
- Scientific Director San Gallicano Dermatological Institute IRCCS, Rome, Italy
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Prior A, Anania P, Pacetti M, Secci F, Ravegnani M, Pavanello M, Piatelli G, Cama A, Consales A. Dermoid and Epidermoid Cysts of Scalp: Case Series of 234 Consecutive Patients. World Neurosurg 2018; 120:119-124. [PMID: 30189303 DOI: 10.1016/j.wneu.2018.08.197] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Dermoid and epidermoid cysts are among the most frequent lesions of the scalp in the pediatric population. Optimal management of a suspected dermoid or epidermoid cyst in children is debated: Some authors advocate conservative management on the basis of the benign histology of these entities, while others prefer surgical excision. OBJECTIVE Our objective is to demonstrate that excision of dermoid and epidermoid cysts is a safe procedure and that early surgery is effective in preventing potential complications related to cyst growth. METHODS We retrospectively collected data on patients who underwent surgery for excision of proven dermoid or epidermoid cysts between January 2006 and October 2017. RESULTS In 234 patients, 237 cysts were excised. Mean age at presentation was 26.99 ± 32.7 months; 48.7% of patients were operated on between 1 and 3 years of age, and 32.9% were younger than 1 year of age. Cysts were more frequently located in the frontal bone than in occipital and supraorbital regions. In 36.28% of cases there was no significant cranial impingement, while 21.94% of the cysts eroded through a partial thickness of the cranium, 12.23% were in the full thickness of the skull, and 0.84% had epidural extension. We identified 22 intradiploic cysts. Statistical analysis demonstrated significant association between frontal and pterional localization and bone erosion. Neither major complications nor cyst recurrence were observed. CONCLUSIONS Excision of dermoid and epidermoid cysts is a safe procedure for neurosurgeons dealing with this disease, even in young patients. Early resection is recommended due to the potential adverse effects that may occur if these cysts are left untreated.
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Affiliation(s)
- Alessandro Prior
- Division of Neurosurgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy; Neurosurgery Unit, Ospedale Policlinico "San Martino", Genoa, and University of Turin, Turin, Italy
| | - Pasquale Anania
- Division of Neurosurgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy; Neurosurgery Unit, Ospedale Policlinico "San Martino", Genoa, and University of Turin, Turin, Italy.
| | - Mattia Pacetti
- Division of Neurosurgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Francesca Secci
- Division of Neurosurgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Marco Pavanello
- Division of Neurosurgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Gianluca Piatelli
- Division of Neurosurgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Armando Cama
- Division of Neurosurgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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Abstract
Nasal dermoids, encephaloceles, and gliomas are rare congenital lesions that result from improper embryologic development. The differentiation between them and a firm understanding of their pathology is necessary to avoid unnecessary complications. In view of their potential intracranial connection, prompt diagnosis and treatment are paramount. The authors review the embryology, diagnoses, radiologic work-up, surgical management, and complications of these midline craniofacial masses in children.
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Affiliation(s)
- Renae D Van Wyhe
- Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
| | - Edward S Chamata
- Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
| | - Larry H Hollier
- Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
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31
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Naina P, Syed KA, Koshy L, Mathews SS. Sublingual dermoid causing stertor in an infant. BMJ Case Rep 2016; 2016:bcr-2016-217135. [PMID: 27637278 DOI: 10.1136/bcr-2016-217135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Sublingual dermoids are uncommon lesions in the floor of mouth. The most common age of presentation is early adulthood, but presentation in infancy has also been reported. This report highlights the clinical presentation and treatment challenges in infants. An 8-month-old infant presented with inability to close mouth, intermittent stertor and snoring. MRI suggested a sublingual dermoid which was confirmed on histopathology of the surgically enucleated specimen. Sublingual dermoids are uncommon lesions of the floor of mouth. The age of presentation of a sublingual dermoid depends on the initial size of the lesion. Large sublingual dermoids in neonates can present with respiratory embarrassment and need early surgical intervention. Surgical enucleation via an intraoral approach is the treatment of choice with external approach reserved for very large cysts below the mylohyoid. Large sublingual cysts can present with anaesthetic challenges and may need fibreoptic intubation.
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Affiliation(s)
- P Naina
- Department of ENT, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Kamran Asif Syed
- Department of Otorhinolaryngology, Head & Neck Surgery, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Lisa Koshy
- Department of ENT, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Suma Susan Mathews
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
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32
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Bin Manie MA, Al-Qahtani KH, Al Ammar A, Islam T, Otaibi FNA. Epidermoid cyst of the suprasternal region: a rare case report. Braz J Otorhinolaryngol 2016; 86:133-135. [PMID: 27320651 PMCID: PMC9422676 DOI: 10.1016/j.bjorl.2016.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 04/10/2016] [Accepted: 04/27/2016] [Indexed: 11/25/2022] Open
Affiliation(s)
- Manal Al Bin Manie
- King Saud University, College of Medicine, Department of Otolaryngology-Head & Neck Surgery, Riyadh, Saudi Arabia
| | - Khalid Hussain Al-Qahtani
- King Saud University, College of Medicine, Department of Otolaryngology-Head & Neck Surgery, Riyadh, Saudi Arabia.
| | - Ahmed Al Ammar
- King Saud University, College of Medicine, Department of Otolaryngology-Head & Neck Surgery, Riyadh, Saudi Arabia
| | - Tahera Islam
- King Saud University, College of Medicine and Research Center, Riyadh, Saudi Arabia
| | - Faiza N Al Otaibi
- King Saud University, College of Medicine, Department of Otolaryngology-Head & Neck Surgery, Riyadh, Saudi Arabia
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33
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DE Araújo Lima EDN, Novaes MM, Germano AR, Silva JSPD, Souza LBD. MANAGEMENT AND FOLLOW-UP OF EXTENSIVE TERATOID CYST IN MOUTH FLOOR. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2016; 29:126-8. [PMID: 27438042 PMCID: PMC4944751 DOI: 10.1590/0102-6720201600020015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 01/26/2016] [Indexed: 12/22/2022]
Affiliation(s)
| | - Márcio Menezes Novaes
- Universidade Federal do Rio Grande do Norte (Federal University of Rio Grande do Norte), Natal, RN, Brazil
| | - Adriano Rocha Germano
- Universidade Federal do Rio Grande do Norte (Federal University of Rio Grande do Norte), Natal, RN, Brazil
| | | | - Lélia Batista de Souza
- Universidade Federal do Rio Grande do Norte (Federal University of Rio Grande do Norte), Natal, RN, Brazil
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34
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Reddy A, Kreicher KL, Patel NA, Schantz S, Shinhar S. Pediatric epidermoid cysts masquerading as ranulas: A case series. Int J Pediatr Otorhinolaryngol 2016; 81:26-8. [PMID: 26810284 DOI: 10.1016/j.ijporl.2015.11.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 11/25/2015] [Accepted: 11/27/2015] [Indexed: 10/22/2022]
Abstract
Pediatric neck masses represent a variety of differential diagnoses. A common pathology in pediatric cystic neck tumors include ranulas, mucus retention cysts due to salivary gland obstruction. Epidermoid cysts are lesions infrequently encountered in the pediatric population and may appear similarly to ranulas on computed tomography imaging. MRI more easily differentiates these masses, and should therefore be the preferred imaging modality. Due to their distinct intraoperative management, ranulas and epidermoid cysts should be distinguished preoperatively through proper workup.
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Affiliation(s)
- Abhita Reddy
- LSUHSC School of Medicine, New Orleans, LA, USA.
| | - Kathryn L Kreicher
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
| | - Neha A Patel
- New York Eye and Ear Infirmary of Mount Sinai, Department of Otolaryngology, 310 East 14th St. 6th Floor, New York, NY 10003, USA.
| | - Stimson Schantz
- New York Eye and Ear Infirmary of Mount Sinai, Department of Otolaryngology, 310 East 14th St. 6th Floor, New York, NY 10003, USA.
| | - Shai Shinhar
- New York Eye and Ear Infirmary of Mount Sinai, Department of Otolaryngology, 310 East 14th St. 6th Floor, New York, NY 10003, USA.
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35
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Volck AC, Suárez GA, Tasman AJ. Management of congenital midline nasofrontal masses: case report and review of literature. Case Rep Otolaryngol 2015; 2015:159647. [PMID: 25883821 PMCID: PMC4390611 DOI: 10.1155/2015/159647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 03/19/2015] [Indexed: 11/17/2022] Open
Abstract
Epidermoid cysts, dermoids, gliomas, and meningo-/encephaloceles are the most important differential diagnoses in congenital nasofrontal masses. Since they arise from an abnormal fusion during fetal development, intracranial extension of the lesion has to be ruled out radiologically before therapy. Dermoids are the most common entity. We report about a congenital epidermoid cyst of the glabella and nasion that had been growing over the last two years before presentation in a 24-year-old patient. We discuss radiological imaging and the different surgical approaches described in literature.
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Affiliation(s)
- A. C. Volck
- Department of Otolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007 St. Gallen, Switzerland
| | - G. A. Suárez
- Department of Otolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007 St. Gallen, Switzerland
| | - A. J. Tasman
- Department of Otolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007 St. Gallen, Switzerland
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