A rare case of intramedullary epidermoid cyst diagnosed by MRI]

Intramedullary epidermoid cysts are rare entities. A case recently seen on MRI led us to review the literature on the subject. A 9 year old boy developed in a four month-time a spastic paraparesis with a T7-T8 sensitive level. The MRI showed a widening of the spinal cord at the T6 level with an area of decreased signal on T1 weighted images, and a homogeneous round shaped area of increased signal on T2 weighted images. The authors discuss the contribution of MRI to the diagnosis of this lesion. The number of cases of intramedullar epidermoid cysts, like dermoid cysts, diagnosed with this neuroradiological method, is still very limited and the literature only mentions isolated cases.     

Dermoid cyst of the spermatic cord: a rare cause of benign inguinal lump

Dermoid cyst of the spermatic cord is an extremely rare pathology seen at the urological clinic. We present the case of a 26-year-old man who presented with a groin lump, thought to be a lipoma or a hydrocoele of the cord. The final histopathological analysis established the diagnosis of a dermoid cyst.     

Dermoid cyst of the colon

Dermoid cysts are benign cystic teratomas lined by skin and epidermal appendages. We report a dermoid cyst occurring in a 26-year-old female whose chief complaint was irregular vaginal bleeding. Abdominal magnetic resonance image demonstrated a space-occupying lesion in the right lower abdomen. The mass showed hyperintensity on the T2 image and the signal was homogeneous for the interior. During abdominal surgery we made the diagnosis of subserous tumor of the colon and resected the ileocecal portion of the colon. The tumor measured 5.4 x 4.8 x 3.5 cm and was soft and elastic. On cross section, a unilocular cyst filled with atheromatous material was found. Pathological examination revealed a dermoid cyst. In the view of this diagnosis, a simple excision would have been an adequate treatment.     

Dermoid cyst of the scalp: intracranial extension

Intracranial dermoids are rare and are usually associated with cutaneous scalp lesions. Five hundred forty-two scalp lesions were treated in a 22-year period, and were associated with intracranial lesions in three cases. High-risk cases can be identified by clinical and radiological features, confirmed by a computed tomography scan, and then referred for neurosurgical treatment.     

Dermoid cyst of the parotid gland

Dermoid cyst of the parotid gland is a rare clinical entity. Definitive clinical diagnosis is often difficult to determine preoperatively because of the lack of pathognomonic features. The most frequent location of a parotid dermoid cyst is a triangular area lying above the pinna. Imaging studies do not definitely diagnose a parotid dermoid cyst. Although parotid dermoid cyst is (generally) well-encapsulated, complete removal of the cyst wall is not sufficient to cure it, so it is mandatory to perform careful excision of the cyst by parotidectomy, in terms of preserving facial nerve integrity. Histopathology of the parotid gland tumor removed by parotidectomy makes a diagnosis of certainty, by revealing a cyst wall with keratinization of the squamous epithelium and the presence of skin annexes (hair follicles, sweat glands, sebaceous glands). We present a rare case of parotid dermoid cyst in a 21-year-old male patient with symptoms and imaging rather suggestive of arch I branchial cyst and a brief review of data in the medical literature of the last 20 years.     

Dermoid cyst in the adrenal gland

The first case of a dermoid cyst arising from the unilateral adrenal gland is reported with special reference to its embryonal development and imaging analysis.     

Dermoid cyst of the spine in childhood

A 1 year, 10-month-old boy presented with a history of meningitis, a recent neurologic deficit, and myelographic evidence of a thoracic, extradural compressive lesion. The lesion was subtotally totally excised at surgery and found to be a dermoid cyst. Treatment of this uncommon tumor is facilitated by its early recognition and excision before onset of infection. Incomplete removal can result in regrowth.     

Long segment spinal intramedullary dermoid cyst: A case report

IntroductionSpinal intramedullary dermoid is very rare, accounting for <1% of intraspinal tumors. It can be congenital or acquired. They usually present in 2nd or 3rd decade of life in adults. It may or may not associated with spinal dysraphism. It is asymptomatic in most cases, manifest acutely if it ruptures.Long segment involvement of spinal intramedullary tumor in adult without the history of trauma makes this case unique. Fat suppression imaging helps to distinguish adipose tissue from lesions causing hematomyelia in patients presented with intramedullary hyperintensity in both T1 & T2 sequences of MRI spine.Case presentationWe report here a rare case of 30 years old male who presented to us with sudden urinary retention followed by rapidly progressive quadriparesis and paresthesia in his right arm. In MRI, spinal intramedullary tumor was noted from medulla till D5 vertebra. We performed subtotal excision of tumor and sample sent for histopathology which proved it to be intramedullary spinal dermoid cyst.ConclusionLong segment involvement of spinal intramedullary dermoid cyst in adult without history of trauma makes this case different. Fat suppression imaging must be done in patients with intramedullary hyperintensity in both T1 and T2 sequences of MRI spine. Early diagnosis and appropriate management will be helpful in reducing morbidity.     

Dermoid cyst of the lesser omental bursa

An unusual case of dermoid cyst of the lesser omental bursa is reported. In symptomatology these cysts may simulate a gastric carcinoma. Where excision is impossible, marsupialization is an effective procedure.     

Dermoid cyst of the floor of mouth

A case report of a 30-year-old male with a huge suprahyoid neck swelling and causing respiratory as well as oral function difficulties is reported. The mass was enucleated through oral route, following which normal oral functions as well as respiratory ease were restored. The gross appearance was consistent with dermoid form of congenital cyst of the mouth floor.     

Dermoid cyst of the spleen: Report of a case

(Received for publication on May 18, 1998; accepted on Nov. 6, 1998)     

Intratesticular epidermoid cyst: A rare benign tumor

Epidermoid cysts rarely arise within the testis. The incidental discovery of a distinct, intratesticular epidermoid cyst in a nineteen-year-old man is reported. Management by radical orchiectomy is stressed because grossly the tumor is indistinguishable from a malignant testicular tumor.