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Supratentorial dermoid cysts are rare lesions. In eight cases presented here, the lack of recurrence after subtotal removal of the capsule and the good long-term prognosis are emphasized. This finding is in agreement with the literature. The frequent relationship of these lesions with the cavernous sinus suggests a vascular genesis in the development of intracranial dermoid cysts.
The dermoid cyst usually presents as a mass of the nasal dorsum with or without evidence of a fistulous tract, lined by normal skin, including hair. Approximately 50% of the time the dermoid cyst is deeply located and septal distortion, bone erosion, or intracranial connection may on occasion be discovered. The variations in presentation of these cysts have provoked a variety of recommendations regarding surgical excision. Historical approaches are briefly reviewed. The author favors one of three surgical approaches utilizing incisions that offer good exposure and cosmetically favorable scars. These are outlined in detail. Careful preoperative planning is encouraged, as is the intraoperative use of a lacrimal probe, blunt dissection, and the operating microscope.
Spinal dermoid cysts are congenital lesions. Neurological symptoms are related to the affected area of the vertebral canal. The commonest type involves the sacrococcygeal area. Lesions of the cauda equina are found which result in sciatic pain, paresis of the bladder and rectum, flaccid paresis of the legs, and/or sphincter disturbances. The histology is typical and benign. The images on CT and MR provide diagnosis. We report a case of spinal dermoid cyst revealed by chronic urinary retention.
Three hundred fifty cases of immature teratoma of the ovary and 10 cases of ovarian dermoid cyst containing microscopic foci of immature tissue were analyzed to evaluate the relation between the two tumors. Twenty-six percent of the immature teratomas contained grossly visible dermoid cysts, 10% of them were associated with a dermoid cyst in the contralateral ovary, and 9 (2.6%) were preceded by resection of a dermoid cyst from the same ovary. Microscopic foci of slightly or moderately immature tissue were found in the walls of two of the previously excised cysts. Follow-up information available in nine of the 10 cases of dermoid cyst containing microscopic foci of immature tissue revealed no evidence of recurrence 11 months to 7 years postoperatively. Dermoid cysts that were followed by immature teratomas were characterized by high frequencies of multiplicity and rupture of the cysts. The findings suggest a relation between dermoid cysts and immature teratomas that warrants further investigation.
Benign dermoid cysts between 1.5 and 6 cm in diameter were laparoscopically removed in 9 premenopausal women. Cystectomy was performed in eight patients, and unilateral oophorectomy in one. Surgical and postoperative complications were not observed. Chemical peritonitis due to the dermoid contents can be avoided, provided, careful lavage of the peritoneal cavity is performed.
Intradural dermoids are rare congenital tumors representing approximately 0.05% of all intracranial lesions. These benign tumors have a typical appearance on CT and MR due to their lipid components. The complication caused by rupture are the spillage of the fatty material into the cerebrospinal fluid. We report a case of a ruptured dermoid cyst showing fat/fluid levels in both side ventricles and fatty material in the subarachnoid space on CT and MR-imaging and the follow-up over four years after incomplete resection of the tumor.
A dermoid cyst is a tumor frequently located in the external third of the fronto-orbital region. It develops along the line of embryonic fusion of the naso-optic groove, infolding the ectoderm during embryonic development. The classic treatment is complete surgical resection by means of an external approach on the dome of the cyst; consequently, a visible scar is a permanent esthetic sequel. At present, a new technique for the resection of these cysts by means of endoscope-assisted surgery through one or two small incisions behind the front headline is described. The surgical endoscopic technique is made through three main steps: incision, exposure of the cyst, and removal of the cyst. Eighteen patients were operated on from 1999 through 2001 at the Plastic Surgery Service of Argerich Hospital in Buenos Aires, Argentine. In all 18 patients, local anesthesia was used and no peri-operative complications were observed; postoperative control showed minimal edema, and analgesics were not necessary. Sixteen patients (90%) were controlled 2 years after surgery, and no recurrence was detected. The advantages of endoscopic resection may be summarized as follows: 1) a small and occult hair incision; 2) better visualization and a magnified view of the dissected areas, with the result that injury of important anatomical structures can be easily avoided; and 3) the absence of a facial scar in young patients.
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BACKGROUND: Intracranial dermoid cysts are rare congenital neoplasms that are believed to arise from ectopic cell rests incorporated in the closing neural tube. The rupture of an intracranial dermoid cyst is a relatively rare event that typically occurs spontaneously. In the past it was believed that rupture is always fatal, a hypothesis that is not supported by more recently reported cases. The symptoms associated with rupture vary from no symptoms to sudden death. METHODS: The present paper analyzes published cases of ruptured intracranial dermoid cysts in terms of their age profile and their clinical presentation and describes an additional case. RESULTS: Analysis of published cases revealed headache (14 out of 44 patients; 31.8%) and seizures (13 out of 44 patients; 29.5%), to be the most common signs of rupture followed by, often temporary, sensory or motor hemisyndrome (7 out of 44 patients; 15.9%), and chemical meningitis (3 out of 44 patients; 6.9%). CONCLUSION: Headache occurred primarily in younger patients (mean age 23.5 +/- 9.3 years), whereas seizures primarily occurred in older patients (mean age 42.8 +/- 11.3 years). The patients with sensory or motor hemisyndrome associated with rupture of an intracranial dermoid cyst showed a more homogeneous age distribution (mean age 38.4 +/- 23.5 years).
We report a case of a paratesticular epidermoid cyst with a concurrent dermoid cyst of the ipsilateral spermatic cord at the internal inguinal ring. The patient presented for evaluation of a presumed testicular neoplasm. Epidermoid and dermoid cysts were confirmed histologically after local excision. To our knowledge concomitant occurrence of these lesions has not been reported previously. We discuss the pathogenesis, diagnosis and treatment.
We report a rare heterotopic gastrointestinal cyst located in the right submandibular/submental area with histopathologic features that included portions resembling a dermoid cyst. Some theories of pathogenesis are discussed, and an origin of this lesion in entrapped undifferentiated endodermal cells is suggested.
Since ovarian dermoid cyst originates in parthenogenesis of the oocyte, it contains various kinds of tissues. Therefore, some tumor markers are expected to be positive. Clinical features of 174 pathologically confirmed dermoid cysts between Jan., 1985 and Aug., 1989 were reviewed, especially concerning tumor markers. The age of the patients was 11 years to 71 years (Mean 35.0 +/- 0.9 years). The weight of the dermoid cyst was 5g to 2.540g (mean 225.9 +/- 26.3g), while most of them were below 200g. The site of the tumors was similar on both the right and left. CA19-9 showed the highest positive rate of 45.5% (40/80). CA125 was second 12.7% (16/126) in markers with more than 20 examined cases, while the rate for AFP, Ferritin, CEA, LDH and TPA was 2.7% (3/110), 2.6% (1/38), 1.6% (2/128), 0.6% (1/161), 0% (0/24), respectively. SCC, IAP and beta 2-MG were examined in less than 20 cases and the positive rate was 18.8% (3/16), 9.1% (1/11) and 8.3% (1/12), respectively. There was no significant relationship between tumor weight and the CA19-9 concentration. In some cases, the serum CA19-9 concentration was followed up after the operation. The half life of CA19-9 was clinically estimated at 4.9 +/- 1.1 days.
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INTRODUCTION: Dermoid and epidermoid cysts are dysembryogenic tumors representing 1% of all intracranial tumors. They are characterized by slow growth, localization to the middle in relation to the basal cisterns and their benign course. OBJECTIVES: To analyze the clinical and radiological characteristics, and the results of surgical treatment of intracranial dermoid and epidermoid cysts. PATIENTS AND METHODS: We reviewed 18 cases of epidermoid and 3 dermoid intracranial cysts which had been diagnosed and treated during a period of 18 years. All patients were diagnosed by computerized tomography (CT) and the last 15 cases by magnetic resonance (MR). RESULTS: The commonest site was the temporal lobe with 7 cases, followed by the suprasellar region with 4 cases. All patients had peculiar imaging characteristics both on CT (hypodense and with no contrast silhouetted) and on MR (hypointensity in T1 and in T2). They were completely resected in 16 cases. There were 3 episodes of aseptic meningitis and 2 deaths. CONCLUSIONS: Dermoid and epidermoid cysts are characterized by long term clinical symptoms. The commonest site is supratentorial in the midline or in the temporosylvian region. The diagnostic investigation of choice is MR. Treatment is surgical, preferably complete resection. However, after sub-total resection there is a prolonged period of remission.
Dermoid cyst of the omentum is an extremely rare condition. We report a case of multiple dermoid cysts of omentum in a 50 years old woman. The aetiopathogenesis, clinical presentation and relevant literature is briefly reviewed.
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Intracranial dermoid and epidermoid cysts are rare lesions formed from the inclusion of ectodermal elements during neural tube closure. Although not entirely consistent, imaging characteristics on CT and MRI can aid differentiation of dermoids and epidermoids, as can age at presentation, location and tendency to rupture. The distinction between dermoid and epidermoid lesions is important prognostically and may impact on surgical management as a subtotally resected dermoid is less likely to recur than its epidermoid counterpart. The distinction of large dermoid lesions as "giant" adds little to information regarding the natural history or prognosis of these lesions and should be abandoned.
A congenital cystic mass was detected at the suprasternal notch of a seven-month-old male infant. After radiologic examinations including ultrasonography, computed tomography, and magnetic resonance imaging, the cyst was excised and diagnosed as a dermoid cyst. Dermoid cysts of the head and neck are rare lesions, but a midline location is characteristic for these congenital masses. To our knowledge, only two reports have been published, which were similar to our case in localization. Dermoid cysts should be included in the differential diagnosis of midline cysts.