Dermoid cyst of nasal septum in an adult patient

Abstract

Rationale:Nasal dermoid cysts are rare congenital lesions and may present as a midline nasal swelling. Nasal dermoid cysts usually present at birth and are commonly diagnosed by 3 years of age. An incidentally detected nasal dermoid cyst in an adult patient is extremely rare.Patient concern:We report an unusual case of an adult patient with an incidentally diagnosed dermoid cyst of the nasal septum, which presented as a longstanding discharging pit in the nasal columella since childhood.Diagnosis:A preoperative diagnosis of dermoid cyst of the nasal septum was made.Intervention:We performed the external rhinoplasty incision, including a small elliptical incision for removal of the columella pit.Outcome:There has been no evidence of recurrence during the 2-year follow-up.Lessons:An incidentally detected nasal dermoid cyst in an adult patient is extremely rare. The most important point for the preoperative diagnosis of nasal dermoid cysts is to identify the presence or absence of intracranial extension. The treatment of choice for nasal dermoid cysts is complete surgical excision with clear margins.

Combined minimally invasive surgical management of a nasal dermoid sinus cyst affecting the frontal sinus: literature review and new classification.

“…An additional elliptical skin incision is necessary for complete NDSC removal in cases involving opening of the skin of the NDSC sinus tract, which is in accordance with the method used to treat our patient [ 2 , 16 , 17 , 27 , 29 ]. For smaller lesions, resection using only this method is possible [ 11 , 32 ].…”

“…The majority of NDSC cases are diagnosed during childhood between 2 and 3 years of life [ 11 , 16 – 18 ]. This is primarily due to the presence of characteristic signs and symptoms (e.g., external nose deformation or pathognomonic hair concentration protruding from the sinus canal on the skin above the lesion, often accompanied by periodic ‘cheesy’-like sebaceous and keratin discharge) [ 10 , 11 , 13 , 18 ].…”

“…A diagnosis of NDSC is based on a clinical examination accompanied by imaging studies and is finally confirmed with histopathological analysis [ 2 , 12 , 24 , 27 ]. The preoperative assessment of the NDSC anatomy and central nervous system involvement using computed tomography (CT) and magnetic resonance imaging (MRI) is crucial for preoperative preparation [ 2 , 4 , 10 – 13 , 16 , 27 ]. There are specific features in the imaging results which may suggest an intracranial extension, e.g., enlargement of the foramen caecum or bifid crista galli.…”

“…Figure 3 shows the differential diagnosis of NDSCs, such as encephaloceles, teratomas, sebaceous cysts, and hematomas, from fibrosis, lipomas, and fibromas [ 2 , 3 , 10 , 20 , 28 ]. Treatment of NDSCs is based on the possibility of surgical excision, which depends on the location, size, and intracranial extension of the lesion [ 2 , 16 ]. Complications of untreated NDSCs include spontaneous local infection with frontal bone osteomyelitis, and abscess formation, which can be incorrectly interpreted as a lacrimal sac abscess when medial canthus swelling is present [ 10 , 18 , 22 , 29 ].…”

A nose-tip cyst in an elderly patient

“…сообщили о расширении рубца при использовании такого подхода в 60,0% случаев [9] . В настоящее время все большую популярность приобретает открытый ринопластический доступ, в некоторых случаях эндоскопически ассистированный [10][11][12][13] . Последнее обстоятельство объясняется тем, что разрезы лучше всего скрывать, размещая их вдоль границ анатомических областей, имеющих…”