A Middle Cranial Fossa Dermoid Cyst Treated by an Endonasal Endoscopic Approach

Endoscopic Endonasal Surgery for Dermoid Cysts Arising From the Middle Cranial Fossa Floor: A Rare Case Series

OBJECTIVE

Dermoid cysts (DCs) are congenital, slowly growing, and may cause nervous system symptoms. Related literature is limited and mainly includes case reports. We report a case series of DCs originating from the middle cranial fossa floor (MCFF) and investigate their demographic information, clinical characteristics, imaging findings, surgical procedures, and prognostic outcomes.

METHODS

We reviewed the patients with DCs arising from the MCFF undergoing endoscopic endonasal surgery (EES) in our center between 2012 and 2022.

RESULTS

A total of 5 patients with DCs were enrolled (2 males and 3 females), with a mean age of 46.2 years at the onset. All DCs originated from the MCFF with 1 case involving the middle cranial fossa bone and another 1 case affecting the dura mater. One (20.0%) patient had neurological involvement. After admission, all patients received EES with a total resection rate of 100.0% (5 of 5). After a median follow-up of 73.2 months, all patients achieved complete clinical and radiological improvements. No surgical-related complications or relapses were observed during the long-term follow-up.

CONCLUSION

Endoscopic endonasal surgery is considered a safe and effective approach for the treatment of DCs in the MCFF. A larger sample size and longer follow-up time are needed.

Giant Dermoid Cyst Causing Dysphagia and Dyspnea

Dermoid cysts are benign lesions seen in young adults. The second most common localization is the floor of the mouth. They are usually asymptomatic over years but can be symptomatic due to secondary changes or the size. Herein, we report a case of 19-year-old woman who applied to emergency service with dyspnea, dysphagia and enlarging of a mass in the submental region. The patient cannot be entubated because of the mass pushing the tongue base backward closing the laryngeal view. Elective tracheostomy was performed for providing airflow during the operation. After the operation a cystic mass fulfilled with keratin lined by keratinized stratified squamous epithelium in addition to the dermal appendages such as sweat glands and follicular structures were seen histopathologically and the case was diagnosed as dermoid cyst of the submental region. In such patients with quick enlarging of mass causing airway obstructions, the tracheostomy can be the preferable method because of the difficulties in entubation.

A rare localization of pure dermoid cyst in the frontal bone

We report the case of an 84-year-old woman who came to our attention with right palpebral edema associated with pain in the omolateral fronto-orbital region. The patient underwent an MRI scan that revealed a rounded, extracerebral intradiploic cystic lesion with dyshomogeneous signal intensity. Computed tomography (CT) imaging was also performed with reformatted 3D reconstruction. Post-surgical histologic analysis confirmed the diagnosis of intradiploic dermoid cyst. We here report the case and discuss epidemiology, imaging features and work-up of this pathological entity.