Epidermal cysts: A clinicopathological analysis with emphasis on unusual findings

Tsaqilah

et al. 2020

IMCRJ

Epidermoid cyst (EC) is a cyst containing keratin and its breakdown products, that is surrounded by an epidermoid wall. EC can occur in both men and women, especially in young- and middle-aged adults. The clinical features of EC include asymptomatic, well-demarcated, and skin-colored to yellowish subcutaneous or dermal nodules with a punctum on the middle of the lesion which can occur anywhere on the body. This type of cyst is usually solitary with diameter up to 5 cm, or rarely, there are multiple with diameters of more than 5 cm, which is classified as a giant EC. Here, we report a case of generalized multiple ECs with a giant EC on the left gluteal region of a 19-year-old male with complaints of asymptomatic skin-colored nodules with central punctum on the right temple, chest, back, and gluteal regions for five years. Correlation between the clinical and histopathological findings in the form of cysts containing keratin and lined by wall composed of stratified squamous epithelia established the diagnosis of EC. The patient underwent surgical procedures for the skin-colored nodules on the chest, back, and gluteal regions. He also received triamcinolone acetonide intralesional injection for the skin-colored nodule on the right temple. After four months of follow-up, there was no recurrence, and all the skin-colored nodules were completely removed. EC should always be considered when diagnosing a skin-colored nodule even if the manifestations are generalized multiple and giant nodules, as in our case, demonstrating a rare and unusual case of EC, to the best of our knowledge.

Section: Discussionmentioning

confidence: 99%

“…2 A cyst with diameter more than 5 cm is called giant EC and it is a rare clinical occurrence. 5 , 6 Multiple ECs are rarely found 7 and can be seen in patients with severe acne vulgaris. 3 There are several case reports of giant EC on the gluteal region 8 , 9 and several case reports of multiple ECs on hairy scalp.…”

Section: Introductionmentioning

confidence: 99%

An Unusual and Rare Case of Generalized Multiple Epidermoid Cysts with a Giant Epidermoid Cyst

Tsaqilah

et al. 2020

IMCRJ

“…These cysts can occur at any age but do not occur before puberty. They frequently occur on the face, trunk, throat, scalp, scrotum, ear lobe, buttock, and breast, but a giant sebaceous cyst at an uncommon site raises concern [ 3 ]. These also occur in females, typically on the forehead, who work in outdoor environments with an exposure to sunlight and unhygienic conditions.…”

Section: Reviewmentioning

confidence: 99%

Review of Head and Neck Masses in the Indian Population Based on Prevalence and Etiology With an Emphasis on Primary Diagnostic Modalities

Bhasker

2021

Cureus

Head and neck masses are classified as sebaceous cysts (epidermoid cysts), cervical lymphadenopathy, benign lipomas, lymph nodes, thyroid swellings, or tuberculosis lymphadenitis that may be painful or painless, adherent or fluctuant. In spite of this, they have distinct prognoses and pathological features. The anatomical location of the swelling and other demographic manifestations of the patient provide valuable information about the cause and type of swelling. Computed tomography (CT), magnetic resonance imaging, positron emission tomography-CT, and ultrasonography are the gold standard imaging methods for the head and neck examination. These methods are used according to the region considered for the study. Fine-needle aspiration cytology of lymph nodes is known to be effective, simple, and sometimes the only tool for the diagnosis of lymph node malignancies. This review highlights the epidemiological aspect of head and neck masses in the Indian population.

“…Seventy five percent of epidermoid cysts are located intracranially, and the remaining 25 percent are within the diploic space of the skull. (2,3) Nigam et al (4) found in their study that 32% of all cutaneous and subcutaneous epidermoid cysts were located in the region of the head and neck, while 6.7% were in the scalp. Around 23.3% of the patients was in the age range of 21-30 years, while 20.4% was in the age range of 41-50 years.…”

Section: Introductionmentioning

confidence: 98%

Pediatric skull bone defect due to epidermoid cyst

Sinurat

Gultom

2021

Universa Medicina

Background Tumors of the skull usually affect adult patients and less than twenty percent of pediatric patients. As the tumors grow, the surrounding bone may undergo destruction and erosion. When the tumors are located in the fontanel, the timely closure of the fontanel may be inhibited. Epidermoid cysts are benign tumors that are intracranially located and very rarely in the midline of the cranium. Meanwhile about 32% of stratified-squamous epithelial epidermoid cysts affect the head and neck region and only 6.7% occur in the scalp. We report an unusual epidermoid cyst located and growing in the anterior fontanel of a pediatric patient and inhibiting fontanel closure. Case Description A 21-month-old boy and his parents visited our polyclinic because there was a lump on his anterior fontanel since four months before they came to the hospital. The lump was initially the size of a peanut and had grown to become as large as a quail’s egg. The physical examination was normal and the brain CT-scan showed bone destruction without any intracranial lesion. The tumor was excised on the preoperative diagnosis of dermoid cyst. Histopathology examination showed the characteristics of an epidermoid cyst. The cyst had a wall and was full of keratin flakes without hair follicles or sebaceous glands. Follow-up one year after complete excision did not reveal any recurrence. Conclusion Epidermoid cysts in the skull of pediatric patients must be completely excised as soon as possible because their growth can damage the bone and inhibit the closure of the sutures.