Atypical imaging features of posterior fossa's dermoid cyst: Case report and review of literature

Badri, Mohamed; Gader, Ghassen; Bahri, K.; Zammel, I.

doi:10.4103/sni.sni_411_17

Cited by 10 publications

(4 citation statements)

References 11 publications

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“…Dermoid cysts are typically well-defined hypodense masses (-20 to -140 HU) on CT, which is similar in density to fat tissue [12] , [13] , [14] . On MRI, they are usually hyperintense masses on T1-WI, and T2 signals vary from hypo- to hyperintense [12] , [13] , [14] . The “fat” density or SI in the CT or MRI is not due to the adipose tissue but a reflection of the internal composition like cholesterol [15] .…”

Section: Discussionmentioning

confidence: 99%

“…The imaging features of dermoid cysts can vary depending on their contents. Dermoid cysts can rarely be hyperdense on CT and hypointense on T1-WI, which could reflect high protein content, saponification of lipid, or keratinized debris with secondary microcalcification in suspension [12] . The “sack of marbles” appearance which describes multiple fat globules in the cyst is also known as one of the imaging features of dermoid cysts [11] .…”

Section: Discussionmentioning

confidence: 99%

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Dermoid cyst in the subcutaneous tissues of the back: A rare case with multimodal imaging and pathologic correlation

Chung

Kim

Park

et al. 2021

Radiology Case Reports

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Dermoid cysts are lined by keratinizing squamous epithelium and consist of skin appendages such as hair follicles, apocrine glands, and sebaceous glands. They are usually diagnosed during infancy or early childhood, commonly reported in the head and neck region. A dermoid cyst on the back is extremely rare, with only three cases in the pediatric and adult populations. We report a rare case of a dermoid cyst in the subcutaneous layer of the back in an adult. A 75-year-old man presented with a soft, painless mass on his left upper back. Computed tomography revealed a low-density mass nearly identical to the subcutaneous fat in the subcutaneous layer with nodular soft-tissue density components. It was a heterogeneously hyperechoic mass without internal vascularity on ultrasonography. On magnetic resonance imaging, the lesion showed nearly identical signal intensity (SI) to subcutaneous fat on T1 and T2-weighted images. The soft tissue component was intermediately hyperintense on T1- and T2- weighted images with enhancement. This lesion was pre-operatively suspected as a lipoma variant or a well-differentiated liposarcoma/atypical lipomatous tumor because of the fat density or SI and enhancing portion. We demonstrated and reviewed the multimodality imaging features of dermoid cysts at an unusual location and suggested imaging features that could help readers differentiate dermoid cysts from lipomatous tumors. When a mass shows fat density or SI with or without enhancing soft tissue components at the trunk or extremity, dermoid cysts as well as lipomatous tumors could be considered in the differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dermoid cyst in the subcutaneous tissues of the back: A rare case with multimodal imaging and pathologic correlation

Chung

Kim

Park

et al. 2021

Radiology Case Reports

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“…Dermoid cysts are observed in intracranial and intraperitoneal spaces except around the orbit [ 4 , 7 – 10 ]. Therefore, surgeons could misinterpret the findings and approach a dermoid cyst, which contains lipid-rich fluid (as seen in the present case), as a lipoma regardless of the use of endoscopes.…”

Section: Discussionmentioning

confidence: 99%

“…They lead the list of differential diagnosis for tumors found in this part of the body [ 2 ]. Computed tomography (CT) is often performed to confirm the positional relationship between the tumor and the surrounding facial bone as an imaging diagnosis, whereas magnetic resonance imaging (MRI) is sometimes chosen for a qualitative diagnosis [ 3 , 4 ]. A typical dermoid cyst shows isointense or hyperintense signals on T1-weighted images on MRI, while it typically shows hyperintense signals on T2-weighted images [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

A dermoid cyst misdiagnosed as a lipoma due to atypical magnetic resonance images: a case report

et al. 2021

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Background Dermoid cysts are well-known lesions that manifest as subcutaneous tumors around the lateral sides of the eyebrows in young patients. Computed tomography or magnetic resonance imaging (MRI) is often performed to confirm the diagnosis. On the other hand, a lipoma is usually a circular lesion, which is sometimes observed in the upper part of the face. The signals of both T1-weighted and T2-weighted images of MRI of a lipoma are, in general, relatively highly homogenous, and the signals decrease in fat-suppressed images. Therefore, differential diagnosis between a dermoid cyst and a lipoma is usually made with MRI, especially based on fat-suppressed images. Here, we present a case of misdiagnosis of a dermoid cyst as a lipoma because of atypical magnetic resonance images. Case presentation We report a case of a 24-year-old Japanese woman with a dermoid cyst around the lateral edge of the eyebrow. The cyst had been gradually increasing in size for the past 2 years. On MRI, it showed high internal signals on T1- and T2-weighted images. However, the signal intensity decreased homogeneously in the fat-suppressed T2-weighted images. The observed tumor had a yellowish appearance under the endoscope. On the basis of these findings, the lesion was considered a lipoma until it ruptured intraoperatively. The pathological diagnosis confirmed it to be a dermoid cyst. Conclusion Some dermoid cysts contain lipid-rich liquid, and these may be misdiagnosed as lipomas by MRI. When a tumor is located at a common site for a dermoid cyst, the MRI images should be validated carefully if it appears like a lipoma, and the differential diagnosis should be considered carefully.

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Atypical posterior fossa dermoid cysts: unusual but predictable imaging features

et al. 2022

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Atypical imaging features of posterior fossa's dermoid cyst: Case report and review of literature

Cited by 10 publications

References 11 publications

Dermoid cyst in the subcutaneous tissues of the back: A rare case with multimodal imaging and pathologic correlation

Dermoid cyst in the subcutaneous tissues of the back: A rare case with multimodal imaging and pathologic correlation

A dermoid cyst misdiagnosed as a lipoma due to atypical magnetic resonance images: a case report

Atypical posterior fossa dermoid cysts: unusual but predictable imaging features

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