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Yalçın AC, Yalçın N, Çakmak Hİ, Bedir R. Cutaneous Ciliated Cysts: 2 Case Reports and Review of Literature. Am J Dermatopathol 2024:00000372-990000000-00381. [PMID: 38941541 DOI: 10.1097/dad.0000000000002777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
ABSTRACT Cutaneous ciliated cysts are rare benign lesions most commonly seen in the lower extremities of young female patients. There is still ongoing debate about the origin of these cysts, with the most common theories being Mullerian heterotopia and eccrine gland metaplasia. To further increase the data pool, we present 2 new cutaneous ciliated cyst cases and gathered data about all 67 cases of literature. We want to highlight that immunohistochemistry and demographic information may play a key role in distinguishing between the 2 possible origins of this cyst, namely estrogen receptor, progesterone receptor, and carcinoembryonic antigen immunohistochemistry. Estrogen receptor and progesterone receptor nuclear positivity is proof of Mullerian origin, but when they are negative with a positive carcinoembryonic antigen, the most likely origin is eccrine gland metaplasia. We advocate using the terms "Cutaneous Mullerian Cyst" and "Ciliated Cutaneous Eccrine Cyst" instead of "Cutaneous Ciliated Cyst" to accurately indicate their distinct origins.
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Affiliation(s)
- Anıl Can Yalçın
- Department of Pathology, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey; and
| | - Nazlıcan Yalçın
- Department of Pathology, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey; and
| | - Halil İbrahim Çakmak
- Department of Pediatric Surgery, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey
| | - Recep Bedir
- Department of Pathology, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey; and
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Fernández Figueras MT, Alzoghby-Abi Chaker J, Fernandez-Parrado M, García Herrera A, Garrido M, Idoate Gastearena MÁ, Llamas-Velasco M, Monteagudo C, Onrubia J, Pérez Muñoz N, Ríos-Martín JJ, Rodríguez Peralto JL, Rozas Muñoz E, Sanmartín O, Santos-Briz Á, Saus C, Suárez Peñaranda JM, Velasco Benito V, Beato Merino MJ, Fernandez-Flores Á. [Main Types of Cysts in Dermatopathology: Part 2]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2024; 57:97-110. [PMID: 38599743 DOI: 10.1016/j.patol.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/23/2023] [Indexed: 04/12/2024]
Abstract
This is the second article in a two-part series published in this journal, in which we examine the histopathological characteristics, as well as the differential diagnosis, of the main entities that present as cystic and pseudocystic structures in cutaneous biopsy. In this second article, we address ciliated cutaneous cysts, branchial cysts, Bartholin's cysts, omphalomesenteric cysts, thymic cysts, thyroglossal duct cysts, synovial cysts, and median raphe cysts, as well as mucocele, ganglion, and auricular and digital myxoid pseudocysts.
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Affiliation(s)
- María Teresa Fernández Figueras
- Servicio de Anatomía Patológica, Hospital Universitari General de Catalunya, Grupo QuironSant Cugat del Vallès, Barcelona, España
| | | | | | | | - María Garrido
- Servicio de Anatomía Patológica, Hospital Universitario 12 de Octubre, Madrid, España
| | | | - Mar Llamas-Velasco
- Servicio de Dermatología, Hospital Universitario de la Princesa, Madrid, España
| | - Carlos Monteagudo
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia, Valencia, España
| | - José Onrubia
- Servicio de Anatomía Patológica, Hospital Universitario San Juan de Alicante, Alicante, España
| | - Noelia Pérez Muñoz
- Servicio de Anatomía Patológica, Hospital Universitari General de Catalunya, Grupo QuironSant Cugat del Vallès, Barcelona, España
| | - Juan José Ríos-Martín
- Servicio de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, España
| | | | | | - Onofre Sanmartín
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - Ángel Santos-Briz
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Salamanca, Salamanca, España
| | - Carles Saus
- Servicio de Anatomía Patológica, Hospital Universitario Son Espases, Palma de Mallorca, España
| | | | - Verónica Velasco Benito
- Servicio de Anatomía Patológica, Hospital Universitario de Cruces, Barakaldo, Vizcaya, España
| | | | - Ángel Fernandez-Flores
- Servicio de Anatomía Patológica, Hospital Universitario El Bierzo, Ponferrada, León, España.
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Kim YH, Lee J. Cutaneous ciliated cyst on the anterior neck in young women: A case report. World J Clin Cases 2020; 8:4481-4487. [PMID: 33083407 PMCID: PMC7559661 DOI: 10.12998/wjcc.v8.i19.4481] [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: 06/01/2020] [Revised: 08/07/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A cutaneous ciliated cyst (CCC) is a rare, benign tumor in young female adults, which is usually found on the lower extremities.
CASE SUMMARY We found an uncommon location of CCC in the anterolateral cervical area and reviewed the literature. A 20-year-old female complained of a well-defined, painless, palpable mass that started several years ago. The mass was tense and movable and located at the anterolateral aspect of the neck. Imaging showed a non-enhancing round mass. Surgical excision biopsy was performed, and the cystic mass was revealed to be a CCC.
CONCLUSION The rare location of CCC can be found in anterior neck area, which should be another diagnostic option for mass on anterior neck.
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Affiliation(s)
- Yon Hee Kim
- Department of Pathology, Soonchunhyang University Seoul Hospital, Seoul 04401, South Korea
| | - Jihyoun Lee
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul 04401, South Korea
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The Cutaneous Ciliated Cyst in Young Male: The Possibility of Ciliated Cutaneous Eccrine Cyst. Case Rep Med 2015; 2015:589831. [PMID: 26491452 PMCID: PMC4605210 DOI: 10.1155/2015/589831] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 09/15/2015] [Indexed: 12/19/2022] Open
Abstract
Cutaneous ciliated cyst was described as a painless cyst occurring on the lower limbs of women between the ages of 15 and 30 years. The cysts are typically lined by ciliated cuboidal to columnar epithelium with pseudostratified areas and focal squamous metaplasia is occasionally present. Immunohistochemical studies have demonstrated that the cysts are PR and ER positive, similar to the epithelia of the fallopian tubes. However, outliers of cutaneous ciliated cysts, including those in male patients and in unexpected locations such as the scalp, finger, and scapular area, have been reported. Thus, some hypotheses have been proposed including the Mullerian heterotopias, ciliated metaplasia of eccrine sweat glands, and embryonic remnants of the cloacal membrane. We report a rare case of cutaneous ciliated cyst on the left shoulder of a 7-year-old boy and this is the eighth case of cutaneous ciliated cyst in male patients. Moreover, through reviewing the articles, we try to propose the classification of the cutaneous ciliated cysts into the cutaneous Mullerian cysts and the ciliated cutaneous eccrine cysts.
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Cutaneous ciliated cyst of the scalp: a case report of a cutaneous ciliated eccrine cyst and a brief review of the literature. Am J Dermatopathol 2015; 36:679-82. [PMID: 25051045 DOI: 10.1097/dad.0b013e3182a00c09] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cutaneous ciliated cysts (CCC) are rare benign cysts known to occur in the lower extremities of females of reproductive age. Currently, there are 2 theories that attempt to explain the histogenesis of this rare entity. The theory of Mullerian heterotopia provides a plausible histogenetic explanation for the vast majority of CCC. A proposed alternative theory is the ciliated metaplasia of eccrine glands. We believe that previously reported cases of CCC include 2 distinct entities. We report, herein, the first case reported in the literature of a cutaneous ciliated eccrine cyst occurring on the scalp.
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Abstract
Cutaneous ciliated cysts (CCC) are exquisitely rare, benign cystic lesions demonstrating simple, ciliated epithelial linings reminiscent of fallopian tube epithelium. Most commonly, CCC show a predilection for the lower extremities of young reproductive age women and demonstrate immunohistochemical positivity for estrogen and progesterone receptors, supporting the theory that they are derived from ectopic Müllerian rests. PAX-8 is a paired box gene, important in the development of Müllerian and thyroid organs and has utility in the identification of tumors of Müllerian, renal, and thyroid origin. Prompted by the precedent studies on PAX-8 immunohistochemical expression in tumors of Müllerian origin, this article aimed to explore the utility of this antibody in defining the histogenesis of 2 bona fide cases of CCC, both occurring in young reproductive age women. Herein, 2 prototypic index cases of CCC with strong nuclear positivity for estrogen and progesterone receptors are shown to also have positive nuclear staining for PAX-8, further supporting their likely Müllerian origin. These data support the designation of these lesions as cutaneous Müllerian cysts, distinct from potential ciliated cysts of eccrine origin.
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Elston DM. Benign tumors and cysts of the epidermis. Dermatopathology (Basel) 2014. [DOI: 10.1016/b978-0-7020-5527-0.00002-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Affiliation(s)
- Amrut V Ashturkar
- Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Narhe, Pune, India. E-mail:
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Perry KD, Cheng NL, Eberts P, Yang J. Ciliated cells in abdominal or pelvic fine needle aspirations: A case report and review of the literature. Diagn Cytopathol 2011; 41:71-6. [DOI: 10.1002/dc.21750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Accepted: 05/06/2011] [Indexed: 01/11/2023]
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Cutaneous ciliated cyst: a case report with focus on mullerian heterotopia and comparison with eccrine sweat glands. Am J Dermatopathol 2011; 32:731-4. [PMID: 20644463 DOI: 10.1097/dad.0b013e3181d43f01] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Cutaneous ciliated cyst is an exceedingly rare, benign lesion most commonly found in the dermis or subcutis of the lower extremities of young female patients in their second and third decades. The pathogenesis of the cyst is unknown. We report a cutaneous ciliated cyst in the lower extremity of a 13-year-old female patient. On histologic examination, clusters of eccrine sweat glands were observed adjacent to the cyst. Upon comparison of the immunohistochemical profile of the cutaneous ciliated cyst and the eccrine sweat glands, they appeared almost completely unrelated. The histologic, immunohistochemical, and ultrastructural findings of this case and the literature provide evidence in favor of the Mullerian heterotopia theory.
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Pérez Valcárcel J, Peón Currás G, Sánchez Arca ME, Rodríguez Gómez I, Sousa Escandón A. [Cutaneous ciliated cyst of the scrotal skin. A case report with discussion of pathogenesis]. Actas Urol Esp 2009; 32:843-6. [PMID: 19013984 DOI: 10.1016/s0210-4806(08)73944-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Cutaneous ciliated cyst (CCC) is a rare benign lesion predominantly occurring in the lower limbs of young women and exceedingly rare in males. Here, we report a case involving a previously unreported site (i.e., scrotal skin) in a 15-year-old male. We also describe pathologic and immunonohistochemical findings, review the pertinent literature and discuss their pathogenetic mechanisms. We propose that CCC could represent a morphologic pattern encompassing several pathogenetically different entities. Data we provide support the hypothesis that at least a part of CCC, specially those occurring in males, could have their origin in ciliated metaplasia of apocrine sweat glands.
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Benign tumors and cysts of the epidermis. Dermatopathology (Basel) 2009. [DOI: 10.1016/b978-0-7020-3023-9.10002-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Chong SJ, Kim SY, Kim HS, Kim GM, Kim SY, Jung JH. Cutaneous ciliated cyst in a 16-year-old girl. J Am Acad Dermatol 2006; 56:159-60. [PMID: 17097367 DOI: 10.1016/j.jaad.2006.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2006] [Revised: 08/01/2006] [Accepted: 08/03/2006] [Indexed: 12/19/2022]
Abstract
A 16-year-old girl was seen for a painless subcutaneous mass of 1 year's duration. On excisional biopsy, a collapsed cystic structure lined by stratified, ciliated, columnar epithelium was noted; findings were consistent with cutaneous ciliated cyst. Immunohistochemical staining for progesterone receptor and epithelial membrane antigen were positive, whereas it was negative for carcinoembryonic antigen, which supports the theory of heteropia of the ciliated epithelium from the Müllerian epithelium in its histopathogenesis.
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Affiliation(s)
- Su-Jean Chong
- Department of Dermatology, St. Vincent Hospital, The Catholic University, Suwon, Republic of Korea
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