Intradural dermoid cyst. A case report

Intraspinal tumors must be included in the long list of differential diagnosis in the patient presenting with the low-back radicular pain syndrome. These tumors are classified easily by their relationship to the dura, and the type of compression readily discerned by myelography. Intradural dermoid cysts account for 1% of intraspinal tumor, but prompt, meticulous, surgical intervention may result in an excellent outcome.     

Postauricular dermoid cyst: a case report

A rare localization of dermoid cyst in the postauricular region is presented.     

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.     

A case of recurrent-rupture dermoid cyst

A 58-year-old man was seen because of general convulsions. The neurological findings were normal at his first visit, but CT revealed a low density mass in the right hypothalamus with calcification. T1-weighted image revealed multiple high intensity lesions in the subarachnoid space. Only anti-epileptic drugs were prescribed. He was readmitted one year later because of a traffic accident due to convulsions. CT and MRI revealed other new lesions in the bilateral anterior horn. After four uneventful years, follow-up CT revealed a dilation of the third ventricle. MRI using the fat suppression method showed enhancement around the main tumor and the wall of the lateral ventricles and stenosis of the aqueduct. Right frontotemporal craniotomy was performed. Thickening of the arachnoids and floating lipid droplets were seen in the sub-arachnoid space. A yellowish tumor was found in the suprasellar region, adhering to the internal carotid artery. The tumor contained soft yellowish tissue and hair. Only partial removal was carried out because of severe adhesion to perforators. The lamina terminalis was opened after tumor removal. The postoperative course was uneventful except for transient diabetes insipidus.     

Spinal dermoid cyst secondary to myelomeningocele repair: a case report

Dermoid and epidermoid tumors arise from the invagination of epidermal elements into the neural tube during the embryonic period. However, many studies have reported that dermoid and epidermoid tumors occur 5 to 10 years after the first operation on myelomeningocele patients. A seven-year-old male with myelomeningocele which had been repaired in his neonatal period, presented leg pain and deterioration of gait disturbance and urinary incontinence. Neuroradiological examinations revealed a spinal dermoid cyst at the repaired myelomeningocele and tethered spinal cord. We removed the tumor and untethered the tethered spinal cord. Postoperatively, the patient's leg pain, gait disturbance and urinary incontinence improved immediately. Inappropriate surgical treatment of spina bifida may cause a second lesion, which leads to tethered-cord syndrome. We suggest that proper surgical treatment, early checkup and neuroradiological evaluations are very important for spina bifida patients who show signs of neurological deterioration. For the best treatment, neurological, urological and orthopedical follow-up study after the first repair operation is necessary.     

小儿巨大腰椎管内皮样囊肿1例

患儿,男,7岁,以右髋部疼痛半年余为主诉入院。患儿于半年前出现右髋部疼痛,下蹲困难。于当地医院诊断为右髋关节软骨病,经治疗无明显好转。来我院后经腰椎MRI检查诊断为:T12-S2占位性病变。查体:步入病房,痉挛步态,下蹲过程双膝关节向外划弧,患儿腰骶部有一约1 cm×1 cm的皮脂腺囊肿,但局部皮温不高,无破溃。屈髋困难,呈90°,未触及双侧臀肌挛缩带,双下肢肌力正常,托马斯征阳性,右侧膝反射消失,双侧直腿抬高试验阳性,右小腿内侧感觉减退,L4-5压痛,双侧小腿周径膝关节下10 cm;其余运动、反射及感觉正常。患儿无长期肌肉注射史。辅助检查:C…     

Squamous cell carcinoma arising in a dermoid cyst of the ovary. A case report

A case of advanced squamous cell carcinoma arising in a benign cystic teratoma is presented. The carcinoma occurred in a 48-year-old Black patient who died from widespread disease within 5 months of diagnosis. Carcinomatous change in a dermoid cyst is an uncommon occurrence, with a poor prognosis.     

Recurrent epibulbar dermoid cyst treated with amniotic membrane implant a case report

Background

The dermoid cyst considered a cystic teratoma derived from embryonic germinal epithelium is a slow-growing benign tumour. Dermoid cysts may occur in the orbital and periorbital region in paediatric patients and are often recurrent. The surgical approach depends upon the site of the lesion, superficial or deep. To our knowledge, this is the first described case of a patient with resection of dermoid cyst treated with human amniotic membrane implant and topical application of 0.02% mitomycin C.

Case presentation

We present a case of a 12-year-old male with a tumour in the superotemporal region of the right eye (RE). Symptoms included decreased visual acuity (VA), burning eye, foreign body sensation, and photophobia of the affected eye. A physical examination detected blepharospasm. Ophthalmic examination of his RE, fingers count from a 1–2 m distance, showed no improvement with pinhole. Visual acuity was 20/20 on the left eye (LE). The bio-microscopic examination confirmed the presence of a tumour mass (15 mm ×?12 mm) on the surface of the RE, invading the superotemporal sector. The tumour had a lobulated appearance, a shiny and vascularized surface covered by conjunctiva, a pearlescent-pink colour, a medium consistency, was renitent and painless. An ultrasound scan revealed atrophy of the pigmented retinal epithelium with scleral indentation of the RE. A computed tomography (CT) scan revealed a recurrent lesion consistent with an epibulbar dermoid cyst. Surgical excision of the lesion was performed and a human amniotic membrane (HAM) graft and topical 0.02% mitomycin C (MMC) were applied. Histopathological analysis confirmed the diagnosis of recurrent dermoid cyst.

Conclusion

In this case report, we describe a case of recurrent epibulbar dermoid cyst treated with complete resection; topical MMC and HAM implant with good clinical outcome of the lesion and implant adhesion. Resection of a cyst of the ocular surface is not recommended when a large epibulbar dermoid tissue needs to be resected and no HAM graft is available.

     

Sclerosing encapsulating peritonitis secondary to dermoid cyst rupture: a case report

This case report documents the presentation and management of a 26-year-old female patient diagnosed with SEP secondary to dermoid cyst rupture. The authors postulate that acute chemical peritonitis secondary to dermoid cyst rupture can develop into SEP resulting in the clinical features depicted in this case report.     

Orbital dermoid cyst with intratumoral inflammatory hemorrhage: case report

An 85-year-old female presented with a 3-month history of worsening hyperlacrimation and blurred vision following blunt head injury. Her past medical history was unremarkable. Her blood examination identified no abnormal findings. Neuroophthalmological inspection revealed extraocular movement disorder and mild exophthalmos on the affected side. Her visual acuity was not disturbed. Neuroimaging showed a cystic mass located extraconally in the superolateral compartment of the anterior orbit, without enhancement by contrast medium. Surgical exploration resulted in escape of chocolate-colored, liquefied hematoma during dissection. No vascular lesion was found. A grayish-white cyst wall was found adhering strongly to the lateral and superior rectus muscles. The lacrimal gland was not identified. The mass was totally resected. Histological examination indicated dermoid cyst with inflammatory interstitial hemorrhage. No component of vascular malformation or atypia was found. Hyperlacrimation and extraocular movement improved postoperatively. We thought that the previous blunt head injury might have induced intratumoral hemorrhage in the preexisting dermoid cyst and that the escaped contents caused inflammatory irritation, resulting in the hyperlacrimation. Dermoid cyst may show atypical presentation with intratumoral hemorrhage and should always be included in the differential diagnosis of orbital tumor.     

Extramammary Paget disease in a retrorectal dermoid cyst: report of a unique case

Retrorectal (presacral) dermoid cysts are rare entities, also described as mature cystic or monodermal teratomas. We present a unique case arising in a 64-year-old man, in which the lining squamous epithelium showed marked expansion by Paget disease of extramammary type, and discuss the clinical, radiologic, and pathologic findings.     

A case of a ruptured dermoid cyst in the sylvian fissure

A 22-year-old woman was admitted to our department after developing a headache. The neurological findings were unremarkable on her first visit, but CT demonstrated a lot of low-density masses in the subarachnoid space. The largest mass was in the right sylvian fissure. These lesions appeared hyper-intense in T1, T2 and diffusion-weighted MR images. A right frontotemporal craniotomy was performed to remove the main mass lesion in the right sylvian fissure. During surgery, thickening of the arachnoid membrane and floating oily globules were seen in the subarachnoid space. The histopathological examination revealed that the tumor was a dermoid cyst. Follow-up MRI revealed that some of the small lesions had moved since the operation. These findings suggested that the tumor was a ruptured dermoid cyst. The patient's postoperative course was uneventful and her headache disappeared completely.     

A case of ovarian dermoid cyst with bladder perforation

A 60-year-old female presented with the main complaints of hematuria, pain upon urination, and pollakiuria. Simple abdominal X-rays revealed a dumb bell-shaped calculus shadow, and a calculus was detected in the right posterior wall by cystoscopy. At surgery, a left ovarian dermoid cyst accompanied by a calculus that was adhesive and perforating in the right posterior wall of bladder was detected. Twenty-eight cases of ovarian dermoid cyst with bladder perforation including this case are reported.     

Adult onset tethered cord syndrome associated with intradural dermoid cyst. A case report

STUDY DESIGN: A case report and a review of literature. OBJECTIVES: To describe a rare case of adult onset tethered cord syndrome associated with intradural dermoid cyst. SETTING: General Orthopedics, Japan. METHODS: A 50-year-old woman was referred to us because of right leg pain and pollakiuria. Neurological examinations and radiological assessments including myelography, computerized tomography scan and Magnetic resonance image were carried out. We diagnosed it as the adult onset tethered cord syndrome associated with an intradural cystic lesion. RESULTS: The cystic lesion was totally removed following laminectomy from L5 through S4. Histologically, the tumor was diagnosed as a dermoid cyst. CONCLUSIONS: Intradural dermoid could produce adult onset tethered cord syndrome, but it was not reported in the English literatures to our knowledge.     

Thymic papillo-tubular adenocarcinoma containing a cyst: report of a case

We report a case of thymic papillo-tubular adenocarcinoma in a 55-year-old man, who had no symptoms. Sternotomy revealed a tumor in the anterior mediastinum, tightly adhered to the pericardium. It was resected completely. Interestingly, the tumor contained a unilocular cyst filled with mucinous fluid, suggesting that it originated from a pre-existing thymic cyst. Pathological examination of the tumor revealed a primary thymic papillo-tubular adenocarcinoma resembling a tumor of gut origin. Thymic adenocarcinomas, particularly of the tubular subtype, are extremely rare.     

Huge pineal teratoma mimicking a dermoid cyst. Case report

A case of huge pineal teratoma mimicking a dermoid cyst is reported. Although both computed tomography and surgical findings were entirely similar to those of a dermoid cyst, close histological examinations using the serial sectioning technique of a small solid portion attached to the pineal region revealed tissue components of both mesodermal and entodermal origins among mostly epidermal and dermal components. The importance of serial sectioning of the surgical specimens of seemingly a dermoid cyst is stressed.