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 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.

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.

Occurrence of dermoid cyst in the floor of the mouth: the importance of differential diagnosis in pediatric patients

Abstract Lesions in the floor of the mouth can be a challenging diagnosis due to the variety of pathological conditions that might be found in this area. Within a broad range of lesions, attention has to be addressed to those that require specific management, such as a dermoid cyst (DC) and a ranula. Especially in pediatric patients, in whom the failure of diagnosis can postpone the correct treatment and cause sequelae later in life. DC, a developmental anomaly, is managed primarily by surgical resection. On the other hand, ranula is a pseudocyst that may be treated by marsupialization. This article reports a large and painful lesion in the floor of the mouth in a pediatric patient. With a diagnostic hypothesis of ranula, two surgical interventions were performed, but there were recurrences of the lesion. Subsequently, the patient was referred to the Oral and Maxillofacial Surgery Unit for re-evaluation. Computed tomography showed a semi-transparent image suggesting a cystic formation. Another surgical procedure was performed where the lesion was completely removed. Anatomopathological analysis confirmed the diagnosis of DC. The five-year follow-up showed no signs of recurrence. This article indicates that although DC in the floor of the mouth is rare, it should be considered in the differential diagnosis of other diseases in this area. This precaution may be particularly important in the following circumstances: 1) Similar lesions that have different therapeutic approaches and, 2) To prevent future sequelae in pediatric patients.

Extraconal cystic schwannoma mimicking an orbital dermoid cyst / Schwannoma cístico extraconal simulando um cisto dermóide orbitário

ABSTRACT To our knowledge, we report the first case of an extraconal orbital cystic schwannoma in Brazilian literature. The tumor grew slowly and progressively and was associated with minimal eccentric proptosis and diplopia. The radiologic study (orbital computed tomography) revealed a rounded, encapsulated, and extraconal cystic mass in the superior medial region of the right orbit in the supraorbital and supratrochlear nerve topography. An anterior orbitotomy with full excision of the tumor was performed, and the histopathology examination revealed that the tumor was a schwannoma. After the surgery, the patient experienced total remission of his symptoms.

RESUMO Os autores relatam o primeiro caso de schwannoma orbitário extraconal cístico relatado na literatura brasileira. O tumor apresentou aparecimento lento e progressivo, associado a proptose excêntrica e diplopia leves. O exame de imagem (tomografia computadorizada de órbita) revelou uma lesão nodular, arredondada, capsulada, extracônica, cística, na região súpero-medial de órbita direita, na topografia do nervo supraorbitário e supra-troclear. O paciente foi submetido à orbitotomia por via anterior, com exérese integral da tumoração. O exame histopatológico revelou o diagnóstico de schwannoma. Após a cirurgia, o paciente teve regressão total dos sintomas.

Unusual presentation of benign cystic teratoma

Benign Cystic Teratoma [Dermoid cyst] is the most common Germ cell tumor, they rarely grow larger than 15cm in diameter and usually occur in young women with peak incidence between the ages of 20 and 40 years .We report a case of an unusually massive benign cystic teratoma measuring 86cm by 70cm and weighing 21kg, removed from a 58 year old six years post menopausal Para five woman who had been carrying the cyst over a period of twenty years. She had total abdominal hysterectomy and bilateral satpingo-oophorectomy and was discharged on the eighth post operative day