The enlarged myectomy allowed the treatment of a larger area in the wrinkled region without increasing the complications and with excellent results.

-Head and neck dermoid cysts are lesions relatively rare, which usually occur during childhood as solitary lesions. They are often identified and surgically removed at birth, being uncommon in adults. A 23-year-old male presented with a congenital tumor of the anterior fontanelle, which histopathological examination revealed a dermoid cyst. Surgical intervention is the treatment of choice to remove this lesion. The objective of this study is to report the case, once this type of lesion is rare in adults.KEY WORDS: dermoid cyst, epidermoid cyst, anterior fontanelle, adult.Cisto dermóide na fontanela anterior de adulto: relato de caso RESUMO -Cistos dermóides de cabeça e pescoço são relativamente raros e, usualmente, ocorrem na infân-cia como lesões solitárias. Eles são diagnosticados e operados ao nascer, na maioria dos casos; portanto, essa é uma lesão incomum no adulto. Um homem de 23 anos apresentava tumoração congênita na fontanela anterior, cujo exame histopatológico revelou ser cisto dermóide. Foi submetido a tratamento cirúrgico. O objetivo desse estudo é relatar o caso, uma vez tratar-se de condição rara no adulto. PALAVRAS-CHAVE: cisto dermóide, cisto epidermóide, fontanela anterior, adulto.Head and neck dermoid cysts are relatively rare, and usually occur during childhood as solitary lesions 1 . The cysts over the anterior fontanelle represent about 0.1% of all skull tumors and they are identified and surgically removed at an early age. Therefore, this pathology is rarely observed in adulthood. In order to correctly identify these lesions, diagnostic imaging such as simple X-rays and computer tomography (CT) scan are necessary, besides physical evaluation 2 .We report a case of dermoid cyst over the anterior fontanelle in an adult patient. CASEA 23-year-old man seeked medical help at the Neurology department of Instituto Doutor Jose Frota hospital with a mass over the anterior fontanelle, diagnosed as congenital, which increased in size over the years since the birth (Fig 1). The patient did not show neurological symptoms. The CT scan of the skull demonstrated extracranial lesion with cystical appearance, without intracranial communication (Fig 2). During the excision of the lesion, it was observed a cyst containing a viscous, odorless, and greencolored liquid, with hair (Fig 3). The bacterioscopy of this liquid was negative. The cyst was removed together with its walls, the excess of scalp was ressected, and the skull was properly covered with the patient's skin maintaining the natural hair line. A skull depression underneath the lesion could be observed. A drain with continuous suction was positioned and removed after two days containing a serum-bloody secretion. The histopathological exam of the lesion revealed dermoid cyst. There were no surgical intercurrencies, and the patient recovered without complaints and very satisfacted with the functional and aesthetical results. DISCUSSIONAdeloye and Odeku 3 were the first authors to publish a complete description of the dermoid cyst. The congenit...

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