Tratamento cirúrgico do cisto epidermóide situado anteriormente ao osso hióide: relato de caso / The surgery treatament of epidermoid cyst situated anteriorly to the hyoid bone: case report / Tratamiento quirúrgico del quiste epidermoide situado anterior al hueso hioides: reporte de um caso

O cisto epidermóide (CE) é uma má formação cística de desenvolvimento incomum. Ocorre mais comumente na linha média do assoalho da boca, ocasionalmente localiza-se lateralmente ou em outros sítios. A etiologia do CE ainda é incerta, mas acredita-se que esteja associado a remanentes do ectoderma durante a fusão do primeiro e segundo arcos branquiais. A lesão cresce lentamente sem provocar dor, apresentando-se como massa de consistência semelhante à de borracha ou à massa de pão. Seu diagnóstico se dá por meio de exame clínico e exames complementares de imagem como tomografia computadorizada, ressonância magnética e/ou ultrassonografia, entretanto somente com o exame histopatológico é possível um diagnóstico definitivo. A excisão cirúrgica do cisto é o tratamento de escolha. Quando o diagnóstico é precoce e a intervenção correta, o índice de recidiva torna-se raro. Diante da raridade de casos na região maxilo facial e a dificuldade relacionada ao diagnóstico, o presente trabalho tem como objetivos descrever a ocorrência do cisto epidermóide bem como seu diagnóstico através de exame histopatológico/exames de imagem, tratamento cirúrgico e contribuir com a literatura já existente por meio de um relato de caso que foi diagnosticado no Serviço de Patologia Bucal da Universidade de Gurupi, campus Gurupi/TO.

Epidermoid cysts (EC) is an unusually developing cystic malformation that occurs most frequently in the midline of the floor of the mouth, occasionally located laterally or elsewhere. The etiology of the (EC) still uncertain, but it is believed to be associated with remnants of the ectoderm during the fusion of the first and second branchial arches. The lesion grows slowly without causing pain, presenting itself as a mass with a consistency like of rubber or bread dough. Diagnosis of (EC) is made through complementary imaging tests such as computed tomography, magnetic resonance imaging and/or ultrasound, only histopathological examination it is possible to obtain a definitive diagnosis. Surgical excision of cyst is the treatment of choice. When the diagnosis is made early and the intervention is correct, the recurrence rate is rare. Given the rarity of cases in the maxillofacial region and the difficulty related to diagnosis, this study aims to describe epidermoid cysts occurrence and your diagnostic through of histopathologic/imagine exams, surgical treatment and contribute to the existing literature, through a review and description of a clinical case that was diagnosed at the Oral Pathology Outpatient Clinic at the Faculty of Dentistry - University of Gurupi - UNIRG. Gurupi -Tocantins. Brazil.

El quiste epidermoide (CE) es una malformación quística de desarrollo infrecuente. Ocurre más comúnmente en la línea media del piso de la boca, ocasionalmente se localiza lateralmente o en otra parte. La etiología de la FB aún es incierta, pero se cree que está asociada con restos del ectodermo durante la fusión del primer y segundo arcos branquiales. La lesión crece lentamente sin causar dolor, apareciendo como una masa con una consistencia similar a la de la goma o la masa de pan. Su diagnóstico se realiza a través del examen clínico y pruebas de imagen complementarias como tomografía computarizada, resonancia magnética y/o ultrasonografía, sin embargo, solo con el examen histopatológico es posible un diagnóstico defi nitivo. La escisión quirúrgica del quiste es el tratamiento de elección. Cuando el diagnóstico es temprano y la intervención es correcta, la tasa de recurrencia se vuelve rara. Dada la rareza de los casos en la región maxilofacial y la difi cultad relacionada con el diagnóstico, el presente trabajo tiene como objetivo describir la ocurrencia del quiste epidermoide así como su diagnóstico a través del examen histopatológico/pruebas de imagen, tratamiento quirúrgico y contribuir a la literatura existente a través de un reporte de caso que fue diagnosticado en el Servicio de Patología Oral de la Universidad de Gurupi, campus Gurupi/TO.

An Unusual Dermoid Cyst of the Pineal Region: Case Report in a Child

Introduction The pineal gland is a common location for intracranial germ cells, but dermoids are not commonly observed in this area. In the present paper, we discuss the clinical and radiological features as well as the treatment and outcome of this cyst in a 6-year- old child with a pineal dermoid cyst. Case Presentation The patient presented with chronic headache 6 months before admission in 2018. On the first admission, an enhanced lesion with a small cyst was detected in brain imaging. Magnetic resonance imaging (MRI) of the brain at follow-up (2 months after the first presentation) showed enlargement of the cyst size with compression on the adjacent structures. Radical excision of the tumor was performed after the endoscopic biopsy due to pressure exerted on the adjacent structures. Conclusion Dermoid cyst should be considered as a differential diagnosis for enhanced lesions of the pineal region.

Quiste dermoide intraorbitario / Intraorbital dermoid cyst

Este artículo tuvo como objetivo describir las características clínicas, imagenológicas y la evolución posquirúrgica del quiste dermoide intraorbitario. Los quistes dermoides representan entre 3-9 por ciento de todos los tumores intraorbitarios. Se forman por el secuestro del ectodermo entre las líneas de fusión embrionaria de derivados mesodérmicos. La mayoría de los quistes dermoides son superficiales, y se presentan en la infancia temprana como aumentos de volumen discretos en ceja y párpado. Su crecimiento es lento, y generalmente se asocian a las suturas frontocigomática y frontoetmoidal. Es infrecuente su localización intraorbital. Se presenta una paciente femenina de 5 años de edad, quien fue ingresada con proptosis progresiva. Los exámenes imagenológicos mostraron un quiste intraorbitario derecho a nivel del proceso cigomático del frontal con erosión ósea subyacente. Se realizó su resección quirúrgica mediante orbitomía lateral por la técnica de Krönlein. El examen histopatológico informó quiste dermoide. Su evolución fue satisfactoria(AU)

This article aimed to describe the clinical and imaging characteristics of the intraorbital dermoid cyst, and its postoperative evolution. Dermoid cysts represent 3 percent-9 percent of all intraorbital tumors. They result from sequestrum of the ectoderm between the embryonic fusion lines of mesodermal derivatives. Most dermoid cysts are superficial, presenting in early childhood as a discrete volume increase in the eyebrow and the eyelid. Their growth is slow and they are generally associated to the frontozygomatic and the frontoethmoidal sutures. An intraorbital location is infrequent. A case is presented of a female 5-year-old patient admitted for progressive proptosis. Imaging studies showed a right intraorbital cyst at the level of the frontozygomatic process with underlying bone erosion. Surgical resection was performed by lateral orbitotomy with Krönlein's technique. Histopathological examination revealed a dermoid cyst. The patient's evolution has been satisfactory(AU)

Intraconal orbital dermoid cyst: a rare location

Intraconal dermoid cysts are very unusual in routine clinical practice. Clinical symptoms depend upon the site and extension of the lesion. Though rare, proptosis, diplopia, and orbital pain are the presenting symptoms encountered in patients with an intraorbital dermoid cyst. Although radiology can be diagnostic, a complete correlation with the final histopathology is always mandatory for its confirmation. Endoscopic excision of the cyst ensures a complete cure for the disease without any intraoperative/postoperative complications.

Quiste dermoide nasofrontal: presentación de un caso y revisión narrativa / Nasofrontal dermoid cyst: case presentation

Las lesiones de la región nasofrontal en los niños son un reto diagnóstico debido a su rareza, y su potencial comunicación con el sistema nervioso central también aumenta su complicaciones. Dentro de las principales entidades de esta región se encuentran los quistes dermoides, los gliomas nasales y los encefaloceles. Un abordaje diagnóstico y terapéutico inapropiado podría generar desde simples recurrencias hasta fistulas e infecciones en el sistema nervioso central, que podrían contribuir a mayores complicaciones o incluso, poner en riesgo la vida de los pacientes.

Injuries to the naso-frontal region in children are a diagnostic challenge, associated with their rarity, their complexity also implies their potential communication with the central nervous system. Dermoid cysts, nasal gliomas, and encephaloceles are among the main entities in this region. An inappropriate diagnostic and therapeutic approach could generate from simple recurrences (as in our case), to fistulas and infections of the central nervous system that could contribute to greater complications or even put the lives of patients at risk.

Quiste dermoide en base de cráneo con trayecto fistuloso a punta nasal en un paciente pediátrico: reporte de caso / Skull base dermoid cyst fistulizing to the nasal tip in a pediatric patient: case report

El quiste dermoide es una lesión congénita poco frecuente, secundario a una regresión incompleta de tejido ectodérmico, y su incidencia es de 1/20 000-40 000 nacidos vivos. Debe realizarse una resección quirúrgica oportuna para prevenir el compromiso intracraneal y/o las complicaciones. El estudio imagenológico determina su extensión. Se han recomendado diferentes enfoques quirúrgicos, los cuales deben cumplir con los cuatro principios de Pollock. El siguiente estudio presenta el caso de un paciente pediátrico, de nueve meses de edad, con un quiste dermoide en la base del cráneo asociado con un trayecto fistuloso a punta nasal. La resonancia magnética nuclear (RMN) contrastada evidenció una masa quística en la región anterior a la crista galli comunicada con el tracto fistuloso a la punta nasal. El paciente fue llevado a cirugía para realizar la resección del quiste mediante rinoplastia externa combinada con abordaje endoscópico transnasal. Los resultados funcionales y estéticos fueron satisfactorios, sin recurrencia. Se evidenció una fístula de líquido cefalorraquídeo intraoperatoria corregida en el mismo tiempo quirúrgico.

The dermoid cyst is a rare congenital lesion, secondary to an incomplete regression of ectodermal tissue. Its incidence is 1/20,000-40,000 live births. Timely surgical resection must be performed to prevent intracranial involvement and/or complications. Imaging study determines its extension. Different surgical approaches have been recommended; all must adhere to Pollock's 4 principles. The following study presents the case of a pediatric patient, 9 months old, with a dermoid cyst at the skull base with a fistulous path to the nasal tip. Contrasted nuclear magnetic resonance revealed a cystic mass in the region anterior to the crista galli communicated with a fistulous tract at the nasal tip. The patient was taken to surgery for cyst resection by external rhinoplasty combined with a transnasal endoscopic approach with satisfactory functional and aesthetic results, without recurrence. A Cerebrospinal fluid fistula was evidenced, as an intraoperative complication, it was corrected in the same surgical time.

Quiste dermoide latero cervical / Dermoid cyst of the lateral neck

Resumen Introducción: Los quistes dermoides son lesiones de origen ectodérmico poco frecuentes. Solo un 1,6% de ellos, se presenta en el piso de la boca y de éstos, solo un 6% lateralmente en el espacio submandibular. Objetivo: Reporte de caso y revisión de la literatura. Caso clínico: Se presenta un caso de una paciente de 32 años, con un cuadro de 1 año de evolución caracterizado por una lesión de crecimiento lento pero sostenido. Se le realizó la resección de la lesión junto con una submandibulectomía ipsilateral resultando compatible con un quiste dermoide. Discusión: La localización de esta lesión es muy infrecuente. En el estudio histopatológico son lesiones con epitelio pluriestratificado cornificado y anexos cutáneos. El estudio de imágenes orienta a una lesión quística, siendo la resonancia nuclear hoy en día el mejor examen para caracterizar esta lesión. Es una lesión benigna, sin recidivas reportadas cuando la resección ha sido completa.

Introduction: Dermoid cysts are uncommon lesions from ectodermic origin. Only 1.6% arise in the floor of the mouth, and at this site only 6% arise laterally in the submandibular region. Aim: Case report and review of the literature. Clinical Case: 32 years old patient, with a slow growing lesion during 1 year. Complete resection with an ipisilateral submandibulectomy was performed. The pathologic report showed a dermoid cyst. Discussion: The localization of this lesion is very uncommon. In the pathologic report are lesion with pluri stratified cornified epthitelium with skin attachments. Image studies show a cystic lesion being the magnetic resonance the best study to characterize this lesions. Are benign lesions, without recurrence reported when the lesion has been fully excised.

Teratoma extragonadal del omento mayor, una localización poco usual: reporte de caso y revisión de la literatura / Extragonadal teratoma of the greater omentum, an unusual location: case report and review of the literature

Introducción. Los teratomas son masas de células totipotenciales, frecuentes en los ovarios o testículos. Su localización extragonadal es rara, siendo el epiplón aún más infrecuente. Hasta la actualidad se conocen aproximadamente 34 casos similares en la literatura. Presentación del caso. Se presenta una paciente de 61 años, con dolor en hemiabdomen inferior asociado a sensación de masa, con marcadores tumorales negativos e imágenes diagnósticas que muestran una masa encapsulada y calcificación anular interna sugestiva de necrosis grasa antigua versus tumor desmoide. Por la presentación clínica y los hallazgos imagenológicos se decide llevar a laparotomía exploratoria donde se encuentra masa quística dependiente de epiplón, con material sebáceo en su interior entremezclado con pelo y fragmentos óseos, que se reseca en bloque sin complicaciones. El informe del estudio histopatológico finalmente concluyó la presencia de un teratoma quístico maduro con cambios degenerativos. Por evolución satisfactoria se da egreso hospitalario. Discusión. El teratoma quístico extragonadal del epiplón es exótico en la literatura mundial, con escasos reportes de casos. En este caso, la resección mediante laparotomía resultó exitosa y sin complicaciones. Por su baja incidencia, la laparotomía ha sido una opción válida y segura para el manejo, no obstante conocer el caso permite plantear un abordaje con técnicas mínimamente invasivas

Introduction. Teratomas are totipotential cell masses, commonly located in the ovaries or testes. Its extragonadal location is rare, in the omentum being even rarer. To date, approximately 34 similar cases are known in the literature.Case presentation. A 61-year-old female patient is presented, with pain in the lower abdomen associated with a sensation of mass, with negative tumor markers and diagnostic images that show an encapsulated mass and internal annular calcification suggestive of old fat necrosis versus desmoid tumor. Due to the clinical presentation and the imaging findings, it was decided to carry out exploratory laparotomy where a cystic mass dependent on the omentum was found, with sebaceous material intermixed with hair and bone fragments, which was resected in bloc without complications. The histopathological study report finally concluded the presence of a mature cystic teratoma with degenerative changes. Due to satisfactory evolution, he was dis-charged from hospital.Discusion. Extragonadal cystic teratoma of the omentum is exotic in the world literature, with few case reports. In this case, the laparotomy resection was successful and uncomplicated. Due to its low incidence, laparotomy has been a valid and safe option for management, although knowing the case allows us to propose an approach with minimally invasive techniques

Oral hairy polyp in a teenager: case report and literature review / Pólipo piloso oral em um adolescente: relato de caso e revisão de literatura

ABSTRACT Objective: To report an unusual case of oral hairy polyp (HP) and review the literature, providing epidemiological, clinical and histopathological information on this disease. Case description: A 12-year-old male patient was referred to a Stomatology department with a nodule in the posterior midline of the tongue. The patient did not know exactly when it arose or whether it had grown since then. Clinical exam revealed a bulky and mobile pedunculated mass lesion on the dorsum of the tongue, with a diameter of approximately 1 cm. The patient's mother reported no previous health problem. An excisional biopsy was performed, the surgical specimen was sent for anatomopathological analysis, and the findings were compatible with the diagnosis of HP. Comments: Hairy polyp is a rare lesion, especially in the oral region. The literature search revealed only 10 case reports of oral HP published between January 1999 and January 2019, and they revealed a predominance of the disease in female newborns. Two uncommon facts were presented in this case: the patient was male and diagnosis was made at 12 years old.

RESUMO Objetivo: Relatar um caso incomum de pólipo piloso (PP) oral e revisar a literatura para trazer informações epidemiológicas, clínicas e histopatológicas acerca da doença. Descrição do caso: Paciente do sexo masculino, 12 anos de idade, encaminhado ao Departamento de Estomatologia com nódulo na região posterior de linha média da língua. O paciente não soube relatar quando surgiu a lesão e se ela havia crescido desde então. O exame clínico revelou massa pedunculada, volumosa e móvel no dorso da língua, medindo aproximadamente 1,0 cm de diâmetro. A mãe do paciente relatou que ele nunca havia tido nenhum problema de saúde anterior. Foi realizada biópsia excisional e o material foi enviado para análise anatomopatológica, sendo os achados compatíveis com o diagnóstico de PP. Comentários: O pólipo piloso é uma lesão rara, especialmente na região oral. A pesquisa bibliográfica revelou apenas dez relatos de casos de PP oral, publicados entre janeiro de 1999 e janeiro de 2019, sendo observada predominância da doença em recém-nascidos do sexo feminino. Dois fatos incomuns ocorreram neste caso: tratava-se de um paciente do sexo masculino e o diagnóstico se deu aos 12 anos de idade.

Diagnosis, management, and follow-up of extensive dermoid cyst of the submental region

Dermoid cyst (DC) is a cystic lesion of developmental origin and uncertain etiology that rarely affects the floor of the mouth. We report a case of a large lesion found in the submental and submandibular region in a 25-year-old male patient. Computed tomography revealed extensive hypodense lesion in the submental and submandibular space without peripheral enhancement. The microscopical analysis showed a cystic cavity lined by orthokeratinized stratified squamous epithelium. The cystic capsule was composed of dense fibrous connective tissue containing cutaneous attachments, such as sebaceous and sweat glands. The diagnosis of DC was made. The differential diagnosis of expansive sublingual lesions can be clinically challenging due to the similarity with several lesions frequently observed in this region. Herein, we describe a case of extensive DC arising in the floor of the mouth, presenting clinical, imaging, and microscopical features.

Dermoid cyst with cerebellar meningoencephalocele at different locations accompanied by posterior fossa abnormalities: case report

ABSTRACT CONTEXT: Dermoid cysts are well-defined cysts containing sebaceous glands and dermal structures. In the literature, dermoid cysts and associated closure defects have been described in the same locations. CASE REPORT: In this case, a dermoid cyst was found at the base of the mouth with a coexisting closure defect in the occipital calvarium. Additional abnormalities were also observed, including posterior myeloschisis, right cerebellar dysgenesis, vermian hypogenesis and posterior fusion of the second and third vertebrae. The finding of a dermoid cyst located at the base of the mouth is discussed here, with additional imaging findings. CONCLUSION: Dermoid cysts in the head and neck region may be accompanied by posterior fossa abnormalities.

Tomografía computada y resonancia magnética de variantes normales/congénitas de apariencia quística y presentación frecuente en el encéfalo / CT and MRI of Normal/Congenital Variables with Cystic Appearance and Frequent Presence in the Brain

La presentación de una imagen de apariencia quística durante el estudio del encéfalo constituye un hallazgo incidental cada vez más frecuente, pudiendo encontrarse en el espacio extra o intraaxial. Las mismas pueden ser de naturaleza congénita o adquirida, benigna o maligna, ocupantes de espacio con desplazamiento de la línea media o simplemente presentarse sin efecto compresivo alguno. De localización supra o infratentorial, esas imágenes constituyen un desafío diagnóstico, siendo imprescindible su reconocimiento para no solicitar estudios o tratamientos innecesarios. Valoraremos las imágenes de apariencia quística más frecuentes empleando tomografía computada o imágenes de resonancia magnética.

Presence of a cystic formation in brain examination is frequently an incidental finding. They can be intra or extra-axial in location, congenital or acquired, benign or malignant with or without mass effect. Intracranial cysts can be a diagnostic challenge and we should know them to avoid unnecessary exams or treatment. We will analyze the most common cystic formations seen in computed tomography and magnetic resonance.

Microsurgical Resection of Craniocervical Dermoid Cyst by Far Lateral Approach: Case Report and Literature Review

Introduction Intracranial dermoid tumors represent a rare clinical entity that accounts for 0.04 to 0.6% of all intracranial tumors. Their location in the posterior fossa is uncommon. Objectives To report the case of a young woman with a posterior fossa dermoid cyst treated by right far lateral approach. Case Report A 17-year-old woman presenting with swallowing difficulties for 6 weeks was referred for a neurological investigation. Amagnetic resonance imaging (MRI) scan showed a hyperintense T1-weighted large expansive lesion occupying the posterior fossa and compressing the anterior face of the brain stem and cerebellum. The patient underwent surgical treatment by right far lateral approach with decompression of vascular and neural structures. The patient presented an uneventful recovery, and was discharged home on the fourth postoperative day without any additional neurological deficits. The anatomopathological analysis confirmed the diagnosis of dermoid cyst. Conclusion The far lateral approach is a safe and feasible route to appropriately treat large posterior fossa dermoid cysts. Decompression of vascular and neural structures is essential to achieve good symptom control.

Intramedullary Dermoid Cyst of the Cervical Spinal Cord ­ C5­C7 Level

Introduction: Inclusion cysts of the spinal cord are rarely intramedullary. Such cysts are commonly located in the lumbar and thoracic regions and are usually associated with congenital spinal dysraphism and dermal sinus. Intramedullary dermoid cysts in the cervical region without spinal dysraphism are extremely rare. To our knowledge, only seven such cases are reported in the literature to date. Materials and Methods: An 18-year-old female patient presented with weakness in all four limbs, more distal than proximal muscle weakness, that had been progressing for 3 years. The magnetic resonance imaging (MRI) showed an intramedullary lesion from C5­ C7 with peripheral ring enhancement. "Whorls" were observed within the lesion on T2 weighted image, with associated excavation of vertebral bodies C5­ C7. Operative procedure and findings: partial laminectomy of C5­ D1was performed. The dura was opened. A small myelotomy was made in the root entry zone. About 1.5 ml of yellowish colored fluid was drained. White shiny debris with hair, whitish pultaceous content and teeth were removed. Complete excision of cyst and its wall was performed. Results The histopathological examination revealed that the cyst wall was lined by stratified squamous epithelium with underlying dermis showing hair follicles, sebaceous glands, adipose tissue and cyst filled with keratin debris suggestive of dermoid cyst. Conclusion: The intramedullary location of the dermoid cyst in the cervical cord and the absence of any congenital spinal dysraphism make this case a very unique and rare entity and warrants its inclusion in the reported cases of rare intramedullary space occupying lesions.

Introdução: Cistos de inclusão da medula espinhal raramente são intramedulares. Tais cistos são comumente localizados nas regiões lombares e torácicas e geralmente estão associados com disrafismo espinhal congênito e sinus dérmico. Cistos dermoides intramedulares na região cervical sem a presença de disrafismo espinhal são extremamente raros. Apenas sete casos foram relatados na literatura até a data do presente estudo. Materiais e Métodos: Uma paciente de 18 anos de idade apresentou fraqueza nos quatro membros, mais distal que proximal, com três anos progressivos de duração. A ressonância magnética apresentou uma lesão intramedular de C5 a C7 com realce do anel periférico. Espirais foram observadas dentro da lesão na imagem ponderada em T2, com escavação dos corpos vertebrais C5­C7. Procedimentos operatórios e achados: realização de laminectomia parcial de C5 a D1. A dura cervical foi aberta. Uma pequena mielotomia foi feita na zona de entrada da raiz. Cerca de 1,5 ml de fluído amarelado foi extraído. Detritos brancos brilhantes com cabelo, polpa esbranquiçada e dentes foram removidos. Foi realizada a excisão completa do cisto com parede de cisto. Resultados O exame histopatológico revelou que a parede do cisto estava alinhada por epitélio escamoso estratificado com derme subjacente apresentando folículos capilares, glândulas sebáceas, tecido adiposo e cisto cheio de detritos de creatinina, sugerindo cisto dermoide. Conclusão: A posição intramedular do cisto dermoide no cordão cervical e a ausência de disrafismo espinhal congênito faz deste um caso único, uma entidade rara, e assegura sua inclusão junto aos casos relatados de lesões raras ocupando espaço intramedulares.

Tumores nasales congénitos de la linea media / Congenital nasal tumors of the midline in ENT

Las masas nasales congénitas de la línea media se presentan con una frecuencia muy baja ­1/20.000 a 1/40.000 nacidos vivos­. Se trata de hallazgos asintomáticos en el recién nacido y son resultado de anomalías congénitas del desarrollo embrionario, que suelen aparecer como masas en la línea media nasal en un punto cualquiera entre glabela y columela. Estas tumoraciones presentan un riesgo elevado de extensión al sistema nervioso central, lo que es especialmente importante tener en cuenta para prevenir consecuencias tales como la fístula de líquido cefalorraquídeo y/o la aparición de meningitis recidivante. Existen gran cantidad de tumores nasales de la línea media que aparecen en el recién nacido o en el lactante y que constituyen diagnósticos diferenciales de las lesiones congénitas antes descriptas. Describiremos brevemente los más frecuentes según nuestra experiencia. AU

Congenital nasal masses of the midline are very rare ­ 1/20,000 to 1/40,000 live births ­. Nasal tumors are asymptomatic findings in the neonate and are caused by congenital abnormalities during fetal development, usually appearing at the nasal midline between the glabella and columella. These tumors are associated with a high risk of extension to the central nervous system; therefore, it is especially important to prevent the development of a cerebrospinal fluid fistula and/or recurrent meningitis. There is a large number of nasal tumors of the midline in neonates or infants in the differential diagnosis of the above-described congenital lesion. Here we briefly describe the most common nasal tumors seen at our department. AU

Fibromatosis intraabdominal mesentérica de identificación postmortem. Reporte de caso / Post mortem identification of Intra abdominal Mesenteric Fibromatosis. Case report

La Fibromatosis Intraabdominal es una entidad rara, de etiología desconocida, benigna, sin riesgo de metástasis, pero de comportamiento clínico muy agresivo. Se presenta el caso de femenina de 47 años de edad con paro de evacuaciones de un mes de evolución, marcada distensión abdominal e intolerancia a la vía oral, quien fue manejada en la emergencia de adultos de un hospital público, sin poder determinar su diagnóstico, quien falleció en su casa 30 días después de su última atención hospitalaria. El diagnostico post-mortem en la autopsia médico legal se estableció como Fibromatosis Intraabdominal. Se requiere un alto índice de sospecha ante esta enfermedad con el fin de proveer manejo adecuado a las complicaciones asociadas y disminuir la mortalidad atribuible a ellas...(AU)

Presentación inusual de quiste dermoide en piso de boca: reporte de caso y revisión de la literatura / Unusual presentation of dermoid cyst in the mouth floor: case report and literature review

Los Quistes Derrmoides son una patología frecuente, pero su localización en la cavidad oral es excepcional; cuando se presentan en el suelo de la boca muestran una tumoración benigna de la línea media. Para el abordaje quirúrgico son factores determinantes su tamaño y las relaciones anatómicas; sin embargo la exéresis intrabucal demuestra beneficios estéticos y funcionales. Se presenta el caso de una paciente de 9 años de edad, con aumento de volumen en el piso de la boca y región submentoniana, de 2 años de evolución, crecimiento lento, progresivo y asintomática. Se realizaron estudios complementarios y bajo anestesia general nasotraqueal, se procedió a su exéresis quirúrgica mediante un abordaje intrabucal. El diagnóstico histopatológico reportó Quiste Dermoide en el suelo de la boca. La paciente no ha tenido recurrencia de la lesión transcurridos 1 año de la cirugía.

The Derrmoid Cysts are a frequent pathology, nevertheless their location in the oral cavity is exceptional, when they occur in the floor of the mouth they show a benign tumor of the midline. Their size and anatomical location are determining factors in the surgical approach; however, the intra-oral exeresis demonstrates aesthetic and functional benefits. We present the case of a 9-year-old patient, with increased volume in the floor of the mouth and submental region, of 2 years of evolution, slow growth, progressive, asymptomatic. Complementary studies were carried out and under nasotracheal general anesthesia, we proceeded to surgical exeresis through an intra-oral approach. The histopathological diagnosis reported a Dermoid Cyst in the floor of the mouth. The patient had no recurrence of the lesion 1 year after the operation. A review is made about the diagnosis and surgical approaches of the Dermoid Cysts.

Surgical Strategy for Dermoid and Epidermoid Tumors of the Posterior Fossa - Experience with 21 Patients

Objective The aim of this paper is to describe our surgical strategy and technique and to identify the best management for posterior fossa dermoid and epidermoid tumors (PFDETs). Methods We retrospectively identified 21 consecutive patients (11 males and 10 females), with a mean age of 33.2 years, a mean follow-up of 6.1 years, and pathologically confirmed PFDETs. Total 17 patients were submitted to the extended retrosigmoid approach. This approach incorporates transverse sigmoid sinus exposure and a generous mastoidectomy. Results Gross total tumor removal was achieved in 16 (76.1%) cases, with no surgical mortality and a recurrence rate of 9.5%. Conclusions The surgical strategies used in this group of patients enabled the total removal of most tumors without surgical mortality and with minimal morbidity and recurrence rates. The extended retrosigmoid approach used is an alternative path regarding cranial base approaches. This approach is quick, simple and safe, and decreases the retraction of the cerebellum.

Objetivos O objetivo deste estudo é descrever a técnica operatória para a melhor abordagem dos tumores dermoides e epidermoides da fossa posterior. Métodos Foram analisados retrospectivamente 21 pacientes (11 masculinos e 10 femininos), com idade média de 33,2 anos e acompanhamento de 6,1 anos, com diagnóstico histopatológico de tumor dermoide ou epidermoide de fossa posterior. Nesse grupo, 17 pacientes foram submetidos a abordagem retrossigmoide estendida. Esta abordagem inclui exposição do seio transverso e sigmoide, além de ampla mastoidectomia. Resultados Remoção cirúrgica total foi alcançada em 16 (76,1%) casos sem mortalidade e com recidiva em 9,5% dos casos. Conclusões As abordagens cirúrgicas utilizadas nesta série permitiram a ressecção total na maioria dos pacientes, sem mortalidade cirúrgica e com morbidade e recorrência mínima. A craniotomia retrossigmoide estendida utilizada é uma boa alternativa para abordagens da base do crânio. É uma abordagem simples, rápida, segura, e que minimiza a retração do cerebelo.