Ultrasound Evaluation of Dermal Sinuses/Fistulas in Pediatric Patients

Hosokawa, Takahiro; Takahashi, Hiroaki; Miyasaka, Yusuke; Ohira, Kenji; Tanami, Yutaka; Sato, Yumiko; Ishimaru, Tetsuya; Kawashima, Hiroshi; Hosokawa, Mayumi; Oguma, Eiji; Yamada, Yoshitake

doi:10.1002/jum.15016

Cited by 15 publications

(10 citation statements)

References 68 publications

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“…Ultrasonography is usually the first imaging modality used for evaluating pediatric patients with a superficial mass. [ 18 19 ] To the best of our knowledge, no study has focused on the association between sonographic findings and the duration of symptoms of pilomatricoma. This knowledge could be useful in ensuring correct and rapid diagnosis of pilomatricoma.…”

Section: Introductionmentioning

confidence: 99%

Sonographic characteristics of pilomatricomas and their association with symptom duration

Hosokawa¹,

Shibuki²,

Tanami³

et al. 2020

Medicine

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This study aimed to investigate the associations between the sonographic findings and duration of symptoms in children with pilomatricoma. This study included 86 children with 95 lesions confirmed to be pilomatricoma after pathological examination. The associations between symptom duration and sonographic observations, including the presence or absence of peritumoral hyperechogenicity, calcification, and vascularity were investigated. The internal echogenicity of each pilomatricoma was scored using a 5-point scale based on echogenic spots and calcification with posterior acoustic shadowing. The Mann–Whitney U and Kruskal–Wallis tests were used for statistical analysis. We found that the absence of peritumoral hyperechogenicity and severity of calcification were associated with increased symptom duration. Calcification, (present, 19.19 ± 18.99 months vs absent, 4.31 ± 3.24 months; P < .01) and peritumoral hyperechogenicity (present, 5.02 ± 5.80 months vs absent, 16.17 ± 18.24 months; P < .01), and grade of internal echogenicity (grade 0/1/2/3/4 = 3 months [1 patient]/4.33 ± 3.26 months [range, 1–12]/4.57 ± 3.46 months [range, 2–12]/10.89 ± 9.17 months [range, 3–28]/35.27 ± 19.16 months [range, 9–60], respectively; P = .01 and <.01) were associated with significant differences in symptom duration. There were no significant between-group differences in vascularity (6.01 ± 7.24 months; range, 1–48 vs 15.50 ± 19.12 months; range, 1–60; P = .08). Pilomatricomas with a relatively short symptom duration were more likely to exhibit peritumoral hyperechogenicity and calcification with less severe posterior acoustic shadowing compared to lesions with a longer symptom duration. These sonographic findings provided useful information that facilitated the correct and rapid diagnosis of pilomatricoma.

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Section: Introductionmentioning

confidence: 99%

Sonographic characteristics of pilomatricomas and their association with symptom duration

Hosokawa¹,

Shibuki²,

Tanami³

et al. 2020

Medicine

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“…However, radiation exposure and the injection of contrast medium within the fistula are major concerns associated with fistulography. Ultrasonography is another diagnostic imaging technique for fistulas [11]. However, patients with severe infection report pain with the use of the probe during the compressive procedure performed for the lesion.…”

Section: Discussionmentioning

confidence: 99%

Congenital Cheek Fistula: A Rare Case of Developmental Abnormality in the Buccal Area

Kitano

Sakakibara

Ishida

et al. 2021

Cureus

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A congenital cheek fistula is a rare malformation in the buccal area. Here, we report the case of a congenital cheek fistula in a 50-year-old woman who visited our clinic with complaints of swelling and pain in her left cheek. Physical examination revealed a small hole in the left corner of the mouth present since birth. She had no other congenital malformations in the maxillofacial region such as an accessory ear and cleft lip. Manual compression of the cheek mass induced serous discharge from the hole. Magnetic resonance imaging (MRI) showed a cystic lesion in the left cheek and a fistula within the orbicularis oris muscle that opened into the small hole. After immediate incision and drainage of the cyst, both the cyst and fistula were surgically resected. The cystic lesion was completely delineated from the boundary of the parotid gland. The orbicularis oris muscle was partially incised to remove the fistula and the surrounding scar tissue. Histopathological examination of the resected specimen revealed a cavity consisting of epithelium inside the fistula. The postoperative course was insignificant. No recurrence of the cyst was observed six months postoperatively. The operative and pathological findings demonstrated that the ectoderm-derived epithelial tissue was enclosed by the mesoderm-derived muscle tissue. The mixture of different germ layer-derived tissues suggested that the fistula was a type of congenital transverse facial cleft induced by malfusion of the mandibular and maxillary prominences during embryonic development. The differential diagnoses of the congenital cheek fistula included orocutaneous fistulas and salivary fistulas. MRI was useful in delineating the border between the lesion and the surrounding tissue.

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“…Simple probing will reveal the direction and depth of the tract. 8 Ultrasound can also provide support for the diagnosis 5,[7][8][9][10]12 ; and only a few case reports described imaging with computed tomography (CT), 2 magnetic resonance imaging (MRI), 4,5 or fistulogram. 6 Ultrasonography allows for visualization of the subcutaneous tract with low echogenicity extending toward the sternoclavicular joint, without a visible connection to the joint or pectoralis major muscle, thus facilitating diagnosis and surgical planning.…”

Section: Discussionmentioning

confidence: 99%

Congenital dermoid sinus of the anterior chest region

Shin

Park

et al. 2020

Pediatric Dermatology

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Congenital dermoid sinus of the anterior chest region (CDACR) is a congenital sinus that has a small skin orifice at the level of the sternoclavicular joint and a tract extending caudally into the subcutaneous tissue, ending blindly. 1,2 Since CDACR is an uncommon congenital malformation, it is sometimes incised and drained after misdiagnosis as an inflamed cyst. However, the clinical features and pathology are characteristic. 2,3 Congenital dermoid sinus of the anterior chest region has also been termed congenital dermoid fistula of the anterior chest region, 1-5 congenital cutaneous fistulas at the sternoclavicular joint, 6 congenital sternoclavicular dermoid sinuses, 7 and congenital peristernal dermal sinuses. 8,9 In most Japanese articles, lesions were

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Ultrasound Evaluation of Dermal Sinuses/Fistulas in Pediatric Patients

Cited by 15 publications

References 68 publications

Sonographic characteristics of pilomatricomas and their association with symptom duration

Sonographic characteristics of pilomatricomas and their association with symptom duration

Congenital Cheek Fistula: A Rare Case of Developmental Abnormality in the Buccal Area

Congenital dermoid sinus of the anterior chest region

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