Iatrogenic epidermoid cyst in the parotid gland: A case report

Abstract

Epidermoid cysts presents as a nodular and fluctuant subcutaneous lesion beneath the skin and are most common in acne-prone areas of the head, neck and back. This cyst often arises after localized inflammation of the hair follicle and occasionally after the implantation of epithelium following trauma and surgery including a biopsy procedure. It is often associated with Gardner syndrome, particularly before puberty. The lesion is normally treated by a surgical excision or enucleation, and recurrence is uncommon. A 27 year old woman complained of a swelling of the left parotid gland when she visited our clinic. A cystic lesion was found in the left parotid gland from the high signal intensity on the MR images. Ultrasonography showed that the cystic lesion was heterogeneous echogenic. Six months earlier, botulinum toxin was injected in her left masseter muscles six months earlier and progressive swelling of the left parotid area was noticed four months after treatment. The lesion was surgically removed. It was encapsulated by a thin wall and filled mainly with keratin. The final diagnosis was an epidermoid cyst.

A Unusual Case of Epidermoid Cyst in Parotid Gland

“…Epidermoid cysts are common skin lesions that consist of epithelium lined cavities which are filled with viscous or semisolid [8] epithelial degradation products. Epidermal cysts of the oral cavity are very rare entity and only 1.6-1.9% of all epidermal cysts are located in [9] the oral cavity.…”

Persistent bleeding following biopsy of an epidermoid cyst within the parotid gland

“…Occasionally, epidermoid cysts can arise in body tissues other than skin, including intracranially, and in very rare cases within glandular tissue such as the parotid or submandibular glands 8. Only a few case reports have been published to date describing epidermoid cysts of the parotid gland, most of which were iatrogenic 3 9–11. Due to the extremely low incidence, epidermoid cysts within the parotid gland can pose a diagnostic dilemma as they must be differentiated from other neoplastic lesions of the parotid such as benign mixed tumours, Warthin’s tumours and malignant salivary gland tumours 12…”