Fluid‐fluid level in a giant epidermal cyst of the buttock

Takemura, Noriko; Fujii, Norikazu; Shibata, Chikako; Kawano, Akiko; Fujimoto, Noriki; Uenishi, Toshiaki; Tanaka, Toshihiro

doi:10.1111/j.1346-8138.2007.00248.x

Cited by 10 publications

(9 citation statements)

References 14 publications

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“…Imaging is seldom preferred, since epidermal cysts are usually slowgrowing unilocular lesions that rarely grow beyond 5 cm. However, when an epidermal cyst occurs under a thick skin such as the buttock (as in our case), it can be multilocular and enlarge enough to have a high rupture risk (4). Consequently, preoperative imaging techniques as MRI and computerized tomography (CT) become vital (1,2,3,4).…”

Section: Discussionmentioning

confidence: 93%

“…Consequently, preoperative imaging techniques as MRI and computerized tomography (CT) become vital (1,2,3,4). Ultrasonography (US) is an easy and cheap method, but is usually preferred for smaller lesions, as it may not demonstrate the whole tumor (6).On the differential diagnosis, it is very important to distinguish epidermal cysts from trichilemmal cysts, steatocystoma multiplex, cystic degeneration, vascular and neurogenic tumors, hemorrhagic lymphangioma, cystic teratoma, ganglion cysts or tumors (2,3,4,5). MRI is an excellent method to rule out neoplasms and true soft-tissue tumors.…”

Section: Discussionmentioning

confidence: 99%

“…However, we describe a case of a giant epidermal cyst bordered between the anal and gluteal region which is considered to be a rare localization. To determine its exact size, nature and relationships with the neighboring organs using MRI was very essential (1,2,3,4).…”

Section: Introductionmentioning

confidence: 99%

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A Mass in the Buttock Growing Over 40 Years, a Giant Epidermal Cyst

Musleh¹,

Aykanat²,

Gulcelik³

et al. 2016

yeditepemj

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Epidermal inclusion cysts are the most common benign soft-tissue lesions of the skin. It is typically recognized as a small and slow-growing palpable mass. We demonstrate an atypical case of a giant mass (11 cm) in the left buttock around the perianal area existing there for more than 40 years. Magnetic resonance imaging (MRI) and excisional biopsy were very helpful to confirm the diagnosis, while a surgical exicion was performed as the choice of treatment.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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A Mass in the Buttock Growing Over 40 Years, a Giant Epidermal Cyst

Musleh¹,

Aykanat²,

Gulcelik³

et al. 2016

yeditepemj

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“…10,11 Epidermoid cysts of the buttock are rare. [12][13][14] Three such occurrences have been reported in male patients ages 39, 75, and 79 years, respectively.…”

Section: Discussionmentioning

confidence: 99%

Sonographic and Magnetic Resonance Imaging of a Massive Epidermoid Cyst of the Pelvis and Buttock

Abulafia

Salame

Zinn

et al. 2009

Journal of Ultrasound in Medicine

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erm cell tumors are most commonly located within the gonads.1 Rare extragonadal locations of these tumors include the retroperitoneum, mediastinum, sacrococcygeum, and central nervous system and are considered to result from aberrant migration of germ cells from the yolk sac during fetal development. [1][2][3][4] We present transvaginal sonographic and magnetic resonance imaging (MRI) findings of a massive epidermoid cyst extending from the pelvis to the buttock. Case ReportA 28-year-old woman, para 1, presented with gluteal pain exacerbated during sitting and walking. Other than endometriosis confirmed by laparoscopy after secondary dysmenorrhea 7 years before her current presentation, her history was unremarkable. On physical examination, the patient was in no acute distress. Vital signs were normal, and her abdomen was soft and nontender. Pelvic examination disclosed a normal-sized uterus and adnexa. A symmetric soft pelvic mass approximately 6 cm in diameter was noted posterior to the uterus. A large cystic mass measuring approximately 10 cm in diameter bulging into the medial aspect of the right buttock was noted.Transvaginal sonography depicted a retroverted uterus with normal ovaries (the right containing a hemorrhagic cyst). A large heterogeneous mass located posterior to the uterus was noted (Figures 1 and 2). The patient was offered yet declined sonography of the right buttock. Magnetic resonance imaging delineated a pelvic mass with a large extrapelvic extension protruding to the medial aspect of the right buttock (Figure 3).

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“…3 Lesions > 5 cm in maximal diameter have been termed 'giant epidermal cysts' (GECs), with only a few case reports in the literature describing their clinical and imaging features. [4][5][6][7][8][9][10][11] With regard to soft tissue tumours in general, clinical features suggestive of malignancy include large masses and those exhibiting recent growth, with any soft tissue lesion >5 cm in maximum diameter quoted as having a 20% likelihood of being malignant. 12 The National Institute for Health and Care Excellence (NICE) guidelines state that if a patient presents with a mass lesion >5 cm, they should be promptly referred to a specialist centre.…”

Section: Introductionmentioning

confidence: 99%

Description of the MRI and ultrasound imaging features of giant epidermal cysts

Pressney

Khoo

Hargunani

et al. 2020

The British Journal of Radiology

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Objectives: Guidelines suggest that lesions over 5 cm in dimension should be referred to a specialist sarcoma centre due to the possibility of malignancy. Few epidermal cysts (ECs) reach or exceed this size and are termed giant ECs (GECs). The purpose of this study is to report on a large series of GECs. Methods: Retrospective review of histologically proven GECs over an 8-year period. Patient demographics with MRI and ultrasound (US) appearances were evaluated. Results: A total of 14 cases were included with eight males and six females. Mean age was 51 years. 11 lesions were oval and three bi-lobed in shape, while 12 demonstrated dermal apposition. All were hyperintense on water-sensitive sequences and isointense to slightly hypointense on T1W imaging. Internal clefts were seen in 13 cases and 11 demonstrated chemical shift artefact (CSA) on MRI. On US, 12 showed well-defined linear hypoechoic clefts, with 66.6% having dis-organised compared with 33.3% peripherally located clefts. One ‘pseudo testis’ pattern and one showing irregular striped echogenicity termed novel ‘pseudo muscle’ appearance. No cases demonstrated internal vascularity on Doppler US. Conclusions: MRI signal findings of GECs are often characteristic with hyperintensity on water-sensitive sequences, dermal apposition, CSA and internal clefts while US features of disorganised or clumped hypoechoic clefts and absence of neovascularity were commonly seen. Recognition of combinations of both US and MRI features of GECs should reduce the requirement for pre-excisional needle biopsy to confirm the diagnosis. Advances in knowledge: 1. Identification of common imaging features of GECs should avoid unnecessary pre-excisional biopsy despite their large size in the appropriate MDT setting. 2. A novel ‘pseudo-muscle’ appearance is described on MRI and US.

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Fluid‐fluid level in a giant epidermal cyst of the buttock

Cited by 10 publications

References 14 publications

A Mass in the Buttock Growing Over 40 Years, a Giant Epidermal Cyst

A Mass in the Buttock Growing Over 40 Years, a Giant Epidermal Cyst

Sonographic and Magnetic Resonance Imaging of a Massive Epidermoid Cyst of the Pelvis and Buttock

Description of the MRI and ultrasound imaging features of giant epidermal cysts

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