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[Dermoid cyst of the anterior fontanelle in children: clinical significance and differentiation from encephalocele].

Dermoid cysts of the anterior fontanel present as a tumor lesion that tenses up when the child cries or strains. Their midline position in the skull, the fact that some of these cysts contain clear fluid and the presence of an underlying bone defect, lead the clinician to the erroneous diagnosis of encephalocele, for which they are sent for consultation. We report a series of five of these cysts (3 dermoid and 2 epidermoid) located over the anterior fontanel, remark on their clinical significance, and stress their differential diagnosis from encephalocele and from other tumor lesions of the anterior fontanel.

Adolescent↗

Laparoscopic treatment of ovarian dermoid cysts: eleven years' experience.

STUDY OBJECTIVE: To compare laparoscopic and open approaches in the management of benign ovarian teratomas (dermoid cysts) with regard to operative outcome, complications, and postoperative follow-up. Factors that predispose to rupture of dermoid cysts during laparoscopic removal and rates of adhesion formation in women with and without cyst rupture during laparoscopic surgery also were considered. DESIGN: Review of cases of women with dermoid cysts who underwent cystectomy either by laparoscopy or laparotomy in our department from 1992 through 2002 (Canadian Task Force classification III). SETTING: The Infertility and Operative Laparoscopy units of the First Department of Obstetrics and Gynecology of the University of Athens, Alexandra Maternity Hospital, Athens, Greece. PATIENTS: Two hundred twenty-two women with an ovarian mass requiring surgical management. Of these, 187 women with benign cystic teratomas underwent laparoscopic cystectomy, and 35 underwent cystectomy by laparotomy. INTERVENTIONS: Cystectomy either by laparoscopy or laparotomy. MEASUREMENTS AND MAIN RESULTS: Potential benefits of operative laparoscopy include reduced blood loss, less postoperative pain, shorter hospital stay, fast recovery, and an excellent cosmetic result. CONCLUSION: Laparoscopy should be considered the method of choice for the removal of benign ovarian cystic teratomas as it offers the advantages of fewer postoperative adhesions, reduced pain, shorter hospital stay, and better cosmetic result. It should be performed by surgeons with considerable experience in advanced laparoscopic surgery.

Adolescent↗

[A case of synchronous double cancer responding to UFT--dermoid cyst with secondary malignant transformation and uterine endometrial adenocarcinoma].

We report here a case of synchronous dermoid cyst with secondary malignant tumor and uterine endometrial adenocarcinoma that responded to UFT. A 35-year-old female complained of abdominal fullness and visited our hospital. She had an abdominal mass which was newborn-head size. We performed right salpingo-oophorectomy and partial omentectomy. The pathological findings were dermoid cyst with secondary malignant transformation. After the operation she had underwent cyclic chemotherapy with CDDP, CPA, THP and 5-FU. After three cycles of chemotherapy, a uterine recurrence was suspected from her uterine endocervical smear test. Then we performed a second operation, but radical surgery was impossible due to the presence of multiple metastases to pelvic lymph nodes. The pathological findings were primary uterine endometrial adenocarcinoma, not metastasis from dermoid cyst with secondary malignant tumor. After the second operation, she was treated with oral UFT (400 mg/day), as she refused chemotherapy and radiotherapy. Two months after the start of UFT, the tumor markers were reduced remarkably, and the patient maintained good QOL throughout the treatment without serious adverse events. We conclude that UFT might be benefical in the treatment of advanced gynecologic cancer.

Adenocarcinoma↗

Neonatal dermoid cyst of the floor of the mouth extending to the midline neck.

We describe a male neonate who presented at birth with a compressible dermoid cyst that extended from the floor of the mouth to the midline of the neck. Ultrasonography revealed a fluid-filled sublingual mass. Magnetic resonance imaging performed when the patient was 1 week old demonstrated a 2-cm, cystic, left-sided, sublingual mass that crossed the midline without extension inferior to the mylohyoid muscle. At 3 months of age, the patient developed a 1-cm, solid, submental mass. At the time of surgery, the lesion had a fibromembranous tract that extended through the myolohyoid muscle to a 1-cm cyst in the submental region. Histologic sections depicted 2 dermoid cysts and a connecting fistula. This case represents the first report (to our knowledge) of a dermoid cyst presenting in a neonate as a mass in the floor of the mouth with extension to the midline of the neck.

Dermoid Cyst↗

[Struma carcinoid tumor within a dermoid cyst as an incidental finding in cesarean section].

A 25-year-old primigravida with breech presentation was admitted near term. During Caesarean section, a dermoid cyst of the right ovary was detected. The dermoid cyst was enucleated, preserving a plum-sized ovary. Histology revealed a strumal carcinoid within the excised dermoid cyst. From the histological point of view it was classified as a tumour of low malignancy. The clinical study provided no evidence of any metastases. On the 14th postoperative day the patient could be discharged from hospital subject to close aftercare control.

Adult↗

Laparoscopic surgery of dermoid cysts--intraoperative spillage and complications.

OBJECTIVE: To assess the risks of complications including intraoperative spillage following laparoscopic dermoid cyst enucleation. STUDY DESIGN: A retrospective case series comparison of 390 patients who had surgery at our hospital from 1992 to 1998 for teratomas of the ovary. RESULTS: 43 patients were treated with laparotomy. Two malignant teratomas were observed in this group. In seven patients, the dermoid cysts were removed as part of a vaginal hysterectomy. Three hundred and forty patients had surgery via laparoscopy. Enucleation of the dermoid cyst in toto using a salvage bag for removal was only possible in few cases without contamination of the abdominal cavity by spillage of cyst contents. There were no serious complications in any patients including those with laparoscopic cystectomies and intraperitoneal spill. CONCLUSION: The laparoscopic treatment of benign teratomas is a safe procedure. Primary laparotomy as well as adenectomy is also to be taken into consideration with young patients, if suspicion of malignancy, rapid growth, doubtful infiltration or large size of tumor is present.

Adolescent↗

[Computer tomography appearances of intracranial epidermoid and dermoid cysts as demonstrated by three cases (author's transl)].

The authors describe the computer tomography appearances of intracranial epidermoid and dermoid cysts as demonstrated by three cases, and review the published literature. Dermoid and epidermoid cysts can be distinguished from each other by their topography (dermoid cysts are found more medially while epidermoid cysts occur on the base of the skull and in the pontocerebellar angle), by the presence or not of calcification (found almost exclusively in dermoid cysts), and by their computer tomography appearances. Both tumors have low densities, below that of the cerebrospinal fluid, but dermoid cysts have lower densities than epidermoid cysts, which can be easily explained by referring to the anatomo-pathological appearance.

Adult↗

Febrile convulsions in an adult as presenting symptom of intracranial dermoid cyst: a case report.

A 32-year-old man had generalized tonic-clonic epileptic seizures associated with episodes of recurrent high fever for 6 years. Repeated physical examinations including neurological status, EEG and nuclear brain scan were negative. Brain CT showed a non-homogeneous parasellar cyst of low density and fat-fluid levels in the lateral ventricles. The diagnosis of intracranial dermoid cyst was confirmed at surgery and histopathologically. Recurrent febrile convulsions and chemical meningitis may be the only clinical manifestations of ruptured dermoid cyst. The CT features of intracranial dermoid cyst are pathognomonic.

Adult↗

Dermoid cyst of the floor of the mouth diagnosed by fine needle aspiration cytology: a case report.

BACKGROUND: Dermoid cyst of the floor of the mouth is a rare, benign lesion requiring surgical intervention. To our knowledge, the preoperative diagnosis of this entity by fine needle aspiration (FNA) cytology has not been previously reported in the cytologic literature. CASE: The patient presented with a massive swelling of the floor of the mouth that displaced the tongue superiorly. A computed tomographic (CT) scan demonstrated a cystic lesion thought to be consistent with a lymphangioma. FNA was performed without complications and demonstrated numerous anucleated and some nucleated squames consistent with a diagnosis of dermoid cyst. Establishment of the correct diagnosis by FNA enabled the surgeon to proceed with the appropriate operation; that outcome might not have been possible had the erroneous CT diagnosis of lymphangioma been trusted. CONCLUSION: A preoperative diagnosis of dermoid cyst of the floor of the mouth was established by FNA. In contrast to reports in the older literature, the FNA procedure caused no complications. In patients presenting with lesions of the floor of the mouth, FNA should be the diagnostic procedure of first choice.

Adult↗

Congenital dermoid cyst of the anterior fontanel in a Japanese infant.

A congenital dermoid cyst located over the anterior fontanel is described in a Japanese infant. This is the sixth reported case of the lesion in Japanese patients. The literature is reviewed, and the concept that dermoid cysts of the anterior fontanel do not predominantly occur in blacks is supported.

Asian People↗

Testicular dermoid cyst in a 10-year-old child: case report and discussion of etiopathogenesis, diagnosis, and treatment.

The case of testicular dermoid cyst in a 10-year-old boy who presented for evaluation of a presumed testicular neoplasm is reported. The dermoid cyst was confirmed histologically on frozen section and local excision was performed. Only 5 cases of testicular dermoid cysts in children have been reported so far. We discuss the etiopathogenesis, diagnosis, and treatment.

Child↗

Squamous cell carcinoma arising from dermoid cyst: Case reports and review of literature.

Malignant transformation of a dermoid cyst is rare, with squamous cell carcinoma (SCC) being the most common type. During a 10-year period in our institution, we encountered only four cases of SCC out of 425 cases of dermoid cyst, an incidence of 0.94%. Two were of old age, in menopausal status (63 and 74 y), while the other two were in their early forties. Three cases presented with pelvic masses while the other one had nonspecific wasting symptoms and later diarrhea. Three were in early stage and have survived to date without evidence of disease at 8, 12, and 116 months after diagnosis. The other case, in stage III, had suboptimal surgery and responded partially to chemotherapy, subsequently progressed after cessation of the drug, and finally died within a year after diagnosis.

Adult↗

Malignant transformation within a dermoid cyst: a case report and literature review.

Malignant transformation within a dermoid cyst is a rare event. The most common transformation is to squamous cell carcinoma. Patients are often elderly and present with advanced disease. The prognosis tends to be very poor. We present a case of locally invasive squamous cell carcinoma arising from a dermoid cyst in a 48-year-old lady. She underwent debulking surgery with no gross residual disease remaining. Within 2 months of the surgery she had recurrent disease and this was resistant to single agent carboplatin chemotherapy. She died 4 months after her initial surgery. We discuss the difficulties in diagnosing such tumours, the poor prognosis and review the various adjuvant treatment strategies that have been used in attempt to improve the outcome.

Carcinoma, Squamous Cell↗

Acute abdomen following dermoid cyst rupture during transvaginal ultrasonographically guided retrieval of oocytes.

We report a case of acute abdomen due to puncture of a dermoid cyst during oocyte aspiration, which required laparotomy. A woman who had undergone an in-vitro fertilization and embryo transfer required hospitalization due to onset of an acute abdomen. An ultrasonographic scan showed a pelvic mass with the features of dermoid cyst. The patient required diagnostic laparotomy which confirmed the presence of a ruptured dermoid cyst with subsequent peritonitis.

Abdomen, Acute↗

Endometriosis co-existing with bilateral dermoid cysts of the ovaries treated by laparoscopy.

Endometriosis co-existing with bilateral dermoid cysts of the ovaries is a rare occurrence although both benign conditions are said to be common in women in the reproductive age group. We present a case of a young woman with primary infertility associated with incapacitating dysmenorrhoea. Sonographic evaluation revealed bilateral ovarian cysts. Video-assisted laparoscopy was performed which revealed bilateral dermoid cysts and endometriotic deposits in the pelvis. The ovarian cysts were enucleated and the endometriotic deposits were endo-coagulated. The patient was treated with GnRH agonist for three months. There have been only two reports of benign and malignant teratomas co-existing with endometriomas.

Adult↗

Inguinal dermoid cyst presenting as an incarcerated inguinal hernia.

A case of an inguinal dermoid cyst presenting as an incarcerated inguinal hernia in a 18-year-old boy is reported. A differential diagnosis of masses in the inguinal region is discussed and includes not only hernias but also gynecologic and vascular lesions. Dermoid cysts must be included in the differential diagnosis. Histologically, these cysts are characterized by an external lining composed of squamous epithelium with an underlying fibroconnective tissue containing hair follicles, sebaceous, eccrine, and apocrine glands. The presence of all the skin appendages in these cysts distinguishes them from epidermoid and sebaceous cysts. The lack of structures foreign to skin differentiates them from dermoids (benign cystic teratomas) in the ovarian, testicular, retroperitoneal, and sacrococcygeal region.

Abdominal Neoplasms↗

Cerebellar dermoid cyst with occipital dermal sinus. Report of two pediatric cases.

Intracranial dermoid cyst is a rare entity accounting for 0.1-0.7% of all intracranial tumors. The most common location is in the posterior fossa, at or near the midline. We present 2 pediatric cases with dermal sinus. The first case presented with clinical signs of increased intracranial pressure and cerebellar symptoms. CT scan showed a large and regular midline posterior fossa cyst without contrast enhancement. The second case was revealed by recurrent meningitis. CT scan showed a midline vermis low-density mass with capsular contrast enhancement. Dermal sinus was found in 2 cases. Complete surgical removal was performed followed, in a second operation, by ventriculoperitoneal shunt in 2 cases. There was no postoperative complication in our patients. The aim of this study is to discuss the clinical aspects of dermoid cyst, especially in cases with dermal sinus, and to review the therapeutic strategies in case of associated hydrocephalus.

Cerebellar Neoplasms↗

[Dermoid cysts of the oral floor. A clinical case report and review of the literature].

The authors report two cases of dermoid cysts of the oral floor. The incidence of this pathology in this region is difficult to assess due to the rarity of reported cases. In particular, dermoid cysts appear to derive from the inclusion of epithelial cells on the median line in the fusion point between the first and second branchial arch. Other pathogenetic causes are however reported in the literature, namely traumatic epidermal implants during fetal development in utero. Dermoid cysts are most frequently manifested between the second and sixth decade of life, although cases of younger and older patients have been reported. All the authors agree that there is no sex-related preference. In general, the patient becomes aware of the pathology due to the gradual deterioration of locoregional functional signals: difficulties related to speech, chewing and swallowing. These symptoms are closely correlated to the size of the lesion. The development of the cyst is usually slow and does not involve painful symptoms, but it may become rapid and painful in the presence of concomitant phlogistic processes. In the first case an 18-year-old patient reported the appearance some 4 years earlier of a swelling measuring approximately 4 x 2 cm, involving the entire front portion of the oral floor; the swelling was spontaneously painful. Having been referred to the authors'attention the patient showed a swelling which was localized on the mid oral floor, the size of a tangerine and with a hard elastic consistency and taut, shiny mucous covering; the swelling was apparently normotrophic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗