Epidermoidzyste der Niere

In contrast to epidermoid cysts of the dermis, epidermoid cysts of the kidneys are rare. We report on a female patient with recurrent renal colic caused by an epidermoid cyst of her right kidney. A malignant tumor was suspected by computed tomography but was ruled out through ureterorenoscopic biopsy. The epidermoid cyst was removed by a partial nephrectomy.     

Familial Epidermoid Cysts of the Spleen: Report of Two Cases

The familial occurrence of epidermoid cysts of the spleen is rare, with only six cases having ever been reported, to our knowledge. We recently diagnosed epidermoid cysts of the spleen in a mother and son. First, a 15-year-old boy was admitted to our hospital for management of blunt abdominal trauma. Computed tomography (CT) showed a ruptured large splenic cyst with an intraabdominal hematoma. We performed a splenectomy, and histopathological examination confirmed the existence of an epidermoid cyst of the spleen. About 2 years and 6 months later, the family physician found that the patient's 41-year-old mother had a large splenic cyst, and she was referred to our hospital for further investigation. CT showed a 10 × 8 cm cyst occupying most of the spleen. The patient underwent splenectomy, and a pathological diagnosis of an epidermoid cyst of the spleen was confirmed. Although the etiology of epidermoid cysts of the spleen is unclear, this familial occurrence may support the hypothesis of congenital malformation as a result of genetic change.     

Epiermoid cyst in the kidney.

Epidermoid cyst of the kidney is a rare entity. In the case here presented, epidermoid cyst was an incidental finding at urography performed in a 67-year-old man in connexion with splenectomy for polycythaemia. The cyst was interpreted as an old tuberculous focus. Two years later partial nephrectomy was performed because of repeated attacks of renal colic and signs of recurrent pyelonephritis. The diagnosis of epidermoid cyst was not made preoperatively in this case, or in the cases described in the literature.     

Laparoscopic resection of epidermoid cyst arising from an intrapancreatic accessory spleen: a case report with a review of the literature

We describe a rare case of epidermoid cyst arising in an intrapancreatic accessory spleen that presented as a cystic mass in the tail of the pancreas, and for which laparoscopic distal pancreatectomy was performed successfully. A 36-year-old woman with a cystic mass in the tail of the pancreas, which had been discovered incidentally at a medical checkup, was referred to our department for further examination. Endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography and positron emission tomography demonstrated a multilocular cyst in the tail of the pancreas without any evidence of malignancy, although differential diagnosis was extremely difficult because of the neoplasm-like appearance of the lesion. Therefore, we performed laparoscopic distal pancreatectomy under a preoperative diagnosis of mucinous cystic neoplasm. Postoperative pathologic examination demonstrated an epidermoid cyst arising from a heterotopic spleen within the pancreas. This is the first report of successful laparoscopic distal pancreatectomy for an epidermoid cyst arising in an intrapancreatic accessory spleen. One virtually has no chance to diagnose an epidermoid cyst in an accessory spleen on the basis of preoperative diagnostic workup, and consequently the type of surgical resection (open vs. laparoscopic) would be conditioned by factors other than the clinical entity suspected at the preoperative period.     

A large epidermoid cyst of breast mimicking carcinoma: A case report and review of literature

INTRODUCTIONTriple assessment of a suspicious breast lesion may not always provide a definite diagnosis. We report a case of epidermoid cyst of breast, which caused diagnostic dilemma in spite of a thorough triple assessment and entailed mastectomy.PRESENTATION OF CASEA 69-year-old woman presented with a large painful retroareolar left breast mass. Clinical examination, ultrasound and mammography were highly suspicious of malignancy. However, core biopsy suggested a benign lesion. Due to size of the lesion and diagnostic uncertainty, various options were discussed with the patient. She opted for a simple mastectomy. The histology confirmed a large epidermoid cyst.DISCUSSIONIt is rare for an epidermoid cyst to present as such an advanced lesion, mimicking carcinoma. Excision of such a large retroareolar ‘benign’ lesion, however, may sometime entail mastectomy. This is the first reported case of an epidermoid cyst of breast necessitating mastectomy.CONCLUSIONDiagnostic dilemma while dealing with a suspected breast cancer is not rare. Involvement of multidisciplinary team as well as patient is important in the decision-making. The report illustrates a rare presentation of a deep seated large epidermoid cyst of breast, which mimicked carcinoma, caused diagnostic confusion and entailed mastectomy. We strongly advocate the option of breast reconstruction in such cases.     

Epidermoid cyst of the ureter: A case report

Epidermal cysts of the upper urinary tract are extremely rare. Only three cases have been reported in the published work written in English, Italian or German. We encountered a case of an epidermoid cyst in the ureter of a 72-year-old male. Findings on urine analysis and radiological examination were useful for establishing a correct diagnosis of epidermoid cyst of the urinary tract.     

Epidermoid cyst originating from an intrapancreatic accessory spleen

We report a rare case of an epidermoid cyst originating from an intrapancreatic accessory spleen, in a 40-year-old Japanese man with no clinical symptoms. A cystic tumor in the pancreatic tail was detected incidentally by abdominal ultrasonography. The patient was referred to the KKR Tachikawa Hospital for further examination of the tumor. Preoperative imaging findings suggested that the tumor was an epidermoid cyst originating from an intrapancreatic accessory spleen. On both pre-and post-contrast computed tomography and magnetic resonance images, the solid compartment of the tumor had the same X-ray attenuation and intensity as the spleen. Upon surgical excision, the mass consisted of solid and cystic components that were macroscopically evident on the preoperative images. Microscopic analysis revealed that the solid component was an accessory spleen in the pancreatic tail, whereas the cystic component was lined with stratified epithelium representative of an epidermoid cyst. This is the thirteenth report (in English) of an epidermoid cyst originating from an intrapancreatic accessory spleen, and the first case to be diagnosed prior to surgery.     

Basal Cell Carcinoma Arising from Epidermoid Cyst: A Case Report

Cutaneous epidermoid cysts are very common lesions, but neoplastic transformation of their epithelium is extremely rare. We describe a patient with basal cell carcinoma arising in the wall of an epidermoid cyst present on the back for 20 years. We emphasize the advisability of a close histologic examination of all cutaneous cysts that are seemingly benign in order to avoid incorrect diagnosis.     

Laparoscopic excision of subdiaphragmatic epidermoid cyst: a case report

Retroperitoneal epidermoid cysts are rare. The authors report a case of an 11-year-old boy with an asymptomatic subdiaphragmatic cyst, which was found incidentally during an investigation for hypertension. At laparoscopy, the cyst was densely adherent to the diaphragm, resulting in a pneumothorax during dissection. Nevertheless, the excision and the diaphragmatic repair could be completed laparoscopically without complication. Microscopic examination showed an epidermoid cyst. No similar case has been reported in the literature.     

Differenzialdiagnose einer Mundbodenschwellung

Epidermoid cysts are malformations that are rarely observed in the oral cavity. Histologically, these cysts may be further classified as epidermoid, dermoid, or teratoid depending on the stratified epithelium. We report the case of an 11-year-old girl who had developed an epidermoid cyst over a period of 4 years, which presented as a soft, painless left-sided sublingual swelling without mucosal lesions. Imaging revealed a cystic formation with a central concrement. The lesion was surgically excised via an intraoral approach and after histological examination was diagnosed as an epidermoid cyst. Differential diagnoses for epidermoid cysts include infections, tumors, mucous extravasation, and sialolithiasis or sialoadenitis of the sublingual gland. If tumors are excised completely recurrence is very rare. In cases of postoperative saliva retention with recurrent inflammation of the salivary gland, submandibulectomy is indicated.     

Penile epidermoid cyst in an elderly patient

Although cutaneous epidermoid cysts are common lesions, penile localization of them is quite rare especially in elderly ages. A case of 70-year-old man with a rapidly growing penile epidermoid cyst that extended to under the symphysis pubis is reported. The cystic mass was excised totally and histopathologic examination revealed the epidermoid cyst. There has been no finding of recurrence for one year follow-up period.     

Giant Multilocular Epidermoid Cyst on the Left Buttock

BACKGROUND: Epidermoid cysts are the most common cysts of the skin. They are generally small and slow-growing and rarely reach more than 5 cm in diameter. OBJECTIVE: We present a patient with a giant multilocular epidermoid cyst. METHODS: A 75-year-old man presented with a giant, soft, painless, tumorlike mass on the left buttock that had gradually enlarged over a 12-year period. Excision of the mass from the surrounding tissue was extremely easy because of a well-defined capsule. RESULTS: The 28 x 14 x 12 cm mass was totally excised. A histopathologic examination revealed that it was an epidermoid cyst. CONCLUSION: This rare case of giant epidermoid cyst was treated successfully by local excision followed by primary closure. Dissection of the mass from the surrounding tissue was extremely easy because of a well-defined capsule.     

膀胱表皮样囊肿1例报告并文献复习

目的：探讨膀胱表皮样囊肿临床特点、诊断和治疗方法。方法：回顾性分析1例膀胱表皮样囊肿患者的临床资料。男,31岁,体检发现膀胱占位人院,超声提示膀胱3cm×4cm×3cm高回声占位,CT提示膀胱内占位,密度高于液性,但低于软组织,无明显强化。结果：患者行手术治疗,行膀胱部分切除术,术中见肿物位于膀胱壁内,白色,表面有被膜,血运差,完整切除肿物,剖开肿物见内容物为白色、豆渣样。病理回报：膀胱壁肿物被覆移行上皮之黏膜下表皮样囊肿。患者术后1周痊愈出院,随访15个月未见肿物复发转移。结论：膀胱表皮样囊肿临床极为罕见,目前国内外文献尚无此类报道。膀胱表皮样囊肿尽管罕见,也应为膀胱肿瘤的鉴别诊断之     

Epidermoid cyst of the testis difficult to make a preoperative diagnosis on the echoic examination: a case report

A case of epidermoid cyst of the testis is presented. The patient was a 64-year-old man who complained of a painless mass in the left scrotum. Physical examination revealed a hen-egg sized enlargement of the left scrotal contents. The ultrasonographic appearance did not show a hyperechoic partition, which is called echogenic rim, a characteristic of this tumor on the echoic examination, and was homogeneous, almost similar to that of a normal testis. Because malignant testicular tumors could not be excluded preoperatively, excisional biopsy of the left testis was performed first. Histological diagnosis was an epidermoid cyst of the testis. As the left testis was almost completely occupied by the tumor and no normal testicular tissue was recognized, we performed orchiectomy additionally. Epidermoid cyst of the testis is a rare benign tumor that accounts for about 1 percent of all testicular tumors. It clinically resembles malignant testicular tumors, and orchiectomy is often performed for treatment. About 154 cases of testicular epidermoid cyst have been reported in the Japanese literature and are reviewed briefly here.     

Adjacent epidermoid cyst and primary central nervous system lymphoma: case report

BACKGROUND: Except for cases with radiotherapy or phacomatosis, multiple primary brain tumors of different histologic types are rare. The authors report the association of an epidermoid cyst and a primary CNS lymphoma. CASE DESCRIPTION: A 66-year-old man with a 20-year history of gait disturbance was admitted because of recently worsening symptoms. Magnetic resonance imaging showed an abnormal mass in the posterior fossa. The mass lesion had the appearance of a cystic tumor with a large mural nodule. Gross total removal of the tumor was performed. Histologic examination disclosed the cystic portion to be an epidermoid, whereas the nodular portion exhibited the histologic and immunohistochemical features of a malignant lymphoma. The lymphoma cells were shown to harbor EBV by in situ hybridization. CONCLUSIONS: To our knowledge, this is the first report of the coexistence of an epidermoid cyst and primary CNS lymphoma. When the lesions are adjacent, a definite preoperative diagnosis can be difficult. Epstein-Barr virus-associated CNS lymphoma is rare among the immunologically normal population. The possible pathogenesis for the coexistence of these 2 tumors is discussed.     

An intradiploic epidermoid cyst of the skull in infancy: case report

An intradiploic epidermoid cyst of the skull in infancy is rare. We report a case of a 7-month-old girl with an intradiploic epidermoid cyst of the left parietal bone. The patient was admitted to the department of pediatrics in, our hospital in March, 2000, complaining of a lump in the scalp with a diameter of 1.5 cm. The pediatrician doubted that it was a case of Langerhans cell histiocytosis (LCH). In addition, as a result of further tests there were no systemic findings to suggest LCH. The skull x-ray showed round radiolucency of the left parietal bone. CT scans showed an iso density intradiploic mass with destruction of the outer table. Because of the fact that the mass was enlarging, the patient was admitted to our neurosurgical service in April, 2000. We excised the lesion to confirm the histological findings. The histological diagnosis was epidermoid cyst. We discuss the clinical feature and treatment strategy for intradiploic epidermoid cyst in infancy.     

A large epidermoid cyst developing in the palm: A case report

INTRODUCTIONEpidermoid cysts, also called atheromas, are frequently observed. These cysts originate mostly in the pilosebaceous apparatus but rarely in areas without hair, such as the palm and sole. The mechanism of their development has been reported to be epidermal inclusion secondary to trauma or human papillomavirus (HPV)-60 infection. We report the patient who developed an epidermoid cyst in the palm without any known cause.PRESENTATION OF CASEA 93-year-old male noticed a mass in the left palm 3 years earlier, was diagnosed with an epidermoid cyst based on incisional biopsy, and underwent incision drainage several times during the 3-year period. However, since the cyst spontaneously ruptured and was infected, debridement and resection of the cyst were performed. The postoperative course was favorable, without signs of infection. The pathological diagnosis of the resected specimen was an epidermoid cyst.DISCUSSIONThis case was a rare epidermoid cyst originating in an area without hair, and there was neither a clear history of injury nor findings strongly suggesting HPV-60 infection. Causes other than repeated loading on the palm could not be considered for epidermal inclusion. To our knowledge, this case is the largest reported epidermoid cyst.CONCLUSIONEpidermoid cysts are frequently observed, but their development in areas without hair is rare, and its mechanism has not been clarified. The association between this cyst and trauma or HPV is clear. However, repeated loading on areas such as the palm that tend to undergo chronic loading can also be a cause, as in this patient.     

肾表皮样囊肿1例报告并文献复习

目的探讨肾表皮样囊肿的临床特点、诊断和治疗方法。方法回顾分析1例肾表皮样囊肿伴肾结石患者的临床资料。结果患者行根治性右肾切除,病理报告为右肾表皮样囊肿。患者术后1周痊愈出院,随访10个月未见肿物复发转移。结论肾表皮样囊肿为罕见的肾脏良性肿瘤,临床上报道极少。临床症状缺乏特异性,诊断较困难,需与肾脏肿瘤、囊性肾癌等相鉴别。     

Lymphoepithelial cyst of the pancreas: A preoperatively diagnosed case based on an aspiration biopsy

This paper reports an extremely rare case of lymphoepithelial cyst of the pancreas. The patient, a 58-year-old man with no subjective symptoms, was found to have a pancreatic tumor during a physical examination. He visited our clinic and was admitted for a follow-up examination. Based on the ultrasonographic findings, superselective angiography, and aspiration biopsy, an epidermoid cyst was diagnosed. Enucleation was easily performed. Macroscopically, this cyst resembled an atheroma. Histologically, the cavity of the cyst was lined with a squamous epithelium with a nucleated layer and below that, lymphatic tissue. No malignancy was found. Tumors of the pancreas with a squamous epithelial covering are extremely rare; only a few such cases have been reported in the literature. As of 1991, only 12 cases, including the present case, had been reported. With the advances in diagnostic techniques, the detection of pancreatic tumors is expected to improve. This paper reports a case in which the use of an aspiration biopsy and superselective angiography proved to be useful in making an accurate diagnosis.     

An atypical site of a retroperitoneal epidermoid cyst in a middle-aged woman

INTRODUCTIONRetroperitoneal cysts are rare, usually asymptomatic, abdominal lesions. Epidermoid cysts developing in this space usually occur in middle-aged women and are incidentally discovered in the presacral region during ultrasound examination. Occasionally, cysts may arise from splenic tissue or adrenal glands and develop above the presacral area.PRESENTATION OF CASEWe present the unusual location of a cyst in the retroperitoneal space in a 41-year-old woman admitted to hospital due to detection of a lesion in ultrasound imaging. A CT scan confirmed large intra-abdominal cyst. At operation, a large retroperitoneal thin-walled cyst with no evident arising point was discovered. Histologic analysis revealed epidermoid cyst.DISCUSSIONOur patient presented with giant retroperitoneal cyst extending from the subhepatic region to the uterine and bladder. To our knowledge, this unusual location in adult has not been previously reported in the literature. In our case the lesion was adjacent to inferior vena cava and mesenteric vessel which required special attention during preparation and was technically demanding.CONCLUSIONSurgery is the gold standard for the diagnosis and treatment of retroperitoneal epidermoid cysts. Successful treatment of benign retroperitoneal epidermoid cysts depends on appropriate diagnosis, careful operative technique, and adequate management of the underlying pathology.