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1.
Medicine (Baltimore) ; 99(10): e18988, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150047

RESUMO

INTRODUCTION: Carbohydrate antigen 19-9 (CA 19-9) is a tumor glycolipid, frequently elevated in the serum of patients due to malignancies from gastrointestinal organs; in particular, the pancreas. This carbohydrate antigen is also expressed in benign diseases. PATIENT CONCERNS: A case of a 27-year-old female who has an unknown origin CA 19-9 elevation for 2 years. DIAGNOSIS: After the left ovarian cystectomy and microscopic examination, the final diagnosis is a dermoid cyst. The dermoid cyst shows increased F-fluorodeoxyglucose (F-FDG) uptake in the F-FDG positron emission tomography (PET)/computed tomography (CT) study. INTERVENTION AND OUTCOMES: The laparoscopic oophorocystectomy was performed. It was observed that the patient's CA 19-9 level returned to normal after the surgery 6 months later. This showed that the dermoid cyst was responsible for the abnormal CA 19-9 level. CONCLUSION: In this case, we can learn that the F-FDG PET/CT scan has potential use in patients with unknown origin of elevation CA 19-9.


Assuntos
Antígeno CA-19-9/sangue , Cisto Dermoide/diagnóstico , Cistos Ovarianos/diagnóstico , Adulto , Biomarcadores Tumorais/sangue , Cisto Dermoide/sangue , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/cirurgia , Diagnóstico Diferencial , Feminino , Fluordesoxiglucose F18 , Humanos , Cistos Ovarianos/sangue , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/cirurgia , Ovariectomia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos
2.
J Craniofac Surg ; 31(2): e155-e156, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31977706

RESUMO

We report an adult case from Kiribati, with a large dermoid cyst, and resultant underlying plagiocephaly, that was managed well with surgical excision. We also discuss the pathogenesis of this condition and the optimum timing for surgical intervention to avoid the deformity.


Assuntos
Cisto Dermoide/cirurgia , Plagiocefalia/complicações , Cisto Dermoide/diagnóstico por imagem , Feminino , Humanos , Tomografia Computadorizada por Raios X , Adulto Jovem
3.
World Neurosurg ; 136: 37-43, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31917306

RESUMO

BACKGROUND: Intramedullary spinal cord dermoid tumors are rare. Early diagnosis with appropriate imaging is of utmost importance for a good outcome. Gross total resection is the treatment of choice for optimal results. Neurosurgical intervention for any intramedullary lesion is fraught with problems because of the nature of the lesion and handling of the spinal cord, which is already compromised because of the intramedullary lesion. Recurrence of the intramedullary dermoid tumor is frequent because of incomplete resection of the tumor. Most commonly, patients present with worsening of neurologic deficits. Inadequate resection because of the fear of worsening the neurologic deficits is associated with significant complications. CASE DESCRIPTION: We report a case of an intramedullary dermoid tumor in a child that was associated with myriad of complications owing to incomplete resection of the tumor. The patient underwent multiple interventions at various centers which resulted in serious multiple complications before presenting at our center for further management. CONCLUSIONS: This report highlights the spectrum of complications that can develop in a patient varying from worsening of the deficits to meningitis and subsequent development of hydrocephalus.


Assuntos
Cisto Dermoide/cirurgia , Hidrocefalia/cirurgia , Meningite Asséptica/terapia , Procedimentos Neurocirúrgicos , Complicações Pós-Operatórias/cirurgia , Sepse/terapia , Neoplasias da Medula Espinal/cirurgia , Derrame Subdural/cirurgia , Descompressão Cirúrgica , Cisto Dermoide/complicações , Cisto Dermoide/patologia , Feminino , Humanos , Lactente , Laminectomia , Vértebras Lombares/cirurgia , Imagem por Ressonância Magnética , Neoplasia Residual , Complicações Pós-Operatórias/diagnóstico por imagem , Reoperação , Sacro , Neoplasias da Medula Espinal/complicações , Neoplasias da Medula Espinal/patologia , Derrame Subdural/diagnóstico por imagem , Vértebras Torácicas/cirurgia , Tomografia Computadorizada por Raios X , Derivação Ventriculoperitoneal
4.
World Neurosurg ; 136: 140-145, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31954900

RESUMO

BACKGROUND: This is a rare case of a patient presenting with epileptic seizures and headaches who was diagnosed with spontaneous intracerebral dermoid cyst rupture via radiographic imagery, and rupture was confirmed via a pathology report. CASE DESCRIPTION: We report the case of a woman aged 26 years who presented with a history of chronic headache for 9 years without other symptoms, and progressive worsening of her headache had occurred for 1 month prior to admission. Radiologic examination showed a large mass located in the left temporal fossa and a large amount of homogeneous matter in the subarachnoid space of the ipsilateral cerebral hemisphere, then the tumor was completely excised. A left pterional craniotomy was conducted under general anesthesia for removal of the tumor, and pathological examination showed a dermoid cyst. CONCLUSIONS: We discuss the clinical and radiologic features, as well as the treatment of this patient.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Cisto Dermoide/diagnóstico por imagem , Epilepsia Parcial Contínua/diagnóstico , Convulsões/diagnóstico , Adulto , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Cisto Dermoide/complicações , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Epilepsia Parcial Contínua/etiologia , Feminino , Cefaleia/etiologia , Humanos , Imagem por Ressonância Magnética , Ruptura Espontânea , Convulsões/etiologia , Espaço Subaracnóideo/diagnóstico por imagem , Tomografia Computadorizada por Raios X
5.
World Neurosurg ; 135: 72-75, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31821914

RESUMO

BACKGROUND: Dermoid cysts are benign, congenital rare lesions, frequently occurring in or near the midline. Rare localizations and variable radiologic findings have been described but remain exceptional. CASE DESCRIPTION: The authors present a rare case of a giant temporoparietal dermoid cyst in an adult female who was paucisymptomatic. No sign of rupture was identified, with a clinical presentation suggesting a slow-growing lesion. Gross total excision was performed with a favorable clinical and radiologic outcome. CONCLUSIONS: Rare localizations previously published in the literature are discussed for dermoid cysts. To our best knowledge, this is the first giant dermoid cyst presenting with this localization.


Assuntos
Cisto Dermoide/cirurgia , Neoplasias Supratentoriais/cirurgia , Encéfalo/diagnóstico por imagem , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/patologia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Supratentoriais/diagnóstico por imagem , Neoplasias Supratentoriais/patologia
6.
World Neurosurg ; 134: 448-451, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31759148

RESUMO

BACKGROUND: Dermoid cysts are benign congenital tumors that develop early in life. These tumors are classified by the presence of all 3 germ layers. Spinal intradural extramedullary teratoma is a rare disease, which is more common in children under 5 years of age than in adults. CASE DESCRIPTION: A 12-year-old girl with a dermoid cyst at the lower lumbar level presented with 2-month low back pain and intermittent lower extremity radicular symptoms on the right side. Magnetic resonance imaging scan of the spine revealed an intradural extramedullary mass lesion at L4-5. Surgical excision of the cyst was successfully performed. Surgical and histopathologic findings confirmed extramedullary ruptured matured teratoma. Postoperatively, the patient had remarkable clinical improvement. CONCLUSIONS: Although dermoid cysts are uncommon, they should be considered in the differential diagnosis of spinal lesions in patients with lower back pain. It can be successfully treated with surgical excision.


Assuntos
Cisto Dermoide/patologia , Neoplasias da Medula Espinal/patologia , Criança , Cisto Dermoide/cirurgia , Feminino , Humanos , Neoplasias da Medula Espinal/cirurgia
7.
Int J Gynaecol Obstet ; 148(3): 392-398, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31828777

RESUMO

OBJECTIVE: To analyze outcomes of IVF treatment among women diagnosed with an ovarian dermoid cyst (DC). METHODS: Retrospective analysis of women with an ovarian DC who underwent IVF with fresh blastocyst transfer at a single center in New York from January 2010 to March 2018. Outcomes were compared between women with conservative treatment and those with surgical excision of the DC. Multivariate logistic regression was used to assess associations between variables and the presence of a DC during treatment. RESULTS: Overall, 119 women with a DC were included. No differences were found in demographic characteristics, controlled ovarian hyperstimulation parameters, and IVF outcomes between women with an intact DC (n=65, 54.6%) and those who underwent cystectomy (n=54, 45.4%) (all P<0.05). Similarly, there was no difference in anti-Mϋllerian hormone and basal antral follicle count among women with a DC (respectively, ß=-0.1, P=0.8, and ß=-1.0, P=0.28) or resected DC (respectively, ß=0.9, P=0.07, and ß=1.5, P=0.08) as compared with control women with no DC (n=352). CONCLUSION: Ovarian reserve, embryo implantation and IVF success rates were not lower in the presence of an ovarian DC. Surgical therapy, if indicated, can be safely postponed until family planning goals have been achieved.


Assuntos
Tratamento Conservador/métodos , Cisto Dermoide/cirurgia , Neoplasias Ovarianas/cirurgia , Teratoma/cirurgia , Adulto , Cisto Dermoide/diagnóstico por imagem , Transferência Embrionária/métodos , Feminino , Fertilização In Vitro/métodos , Humanos , Indução da Ovulação/métodos , Gravidez , Taxa de Gravidez , Estudos Retrospectivos
9.
Am J Case Rep ; 20: 1566-1571, 2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31649234

RESUMO

BACKGROUND Encephalocraniocutaneous lipomatosis is a rare neurocutaneous disorder characterized by cutaneous, ocular, and central nervous system anomalies; its molecular etiology was recently identified. This report describes the surgical treatment and genetic characterization of a giant ocular lipodermoid cyst secondary to encephalocraniocutaneous lipomatosis. CASE REPORT An 11-year-old girl with past medical history of absence seizures presented with a reddish protruding mass in her right eye involving the temporal conjunctiva and the peripheral temporal cornea; eyelid closure was not possible due to mass protrusion. She also presented skin tags at the level of the external canthus and 3 alopecic areas at the level of the scalp compatible with nevus psiloliparus. No family history was reported. A dermoid cyst was suspected and excisional biopsy was performed under general anesthesia. A large conjunctival and lamellar corneoscleral resection was done, followed by a corneal tectonic graft. Molecular analysis was carried out, including PCR and Sanger sequencing on DNA obtained from the mass. After surgery, the patient achieved complete eyelid closure, reduction of ocular surface symptoms, and improved aesthetic appearance. Histological analysis confirmed a lipodermoid cyst; genetic tests confirmed a mosaic activating mutation in FGFR1 (c.1638C>A, p.Asn546Lys). The diagnosis was encephalocraniocutaneous lipomatosis. CONCLUSIONS ECCL is a rare condition; an accurate diagnosis comprising clinical and genetic aspects can facilitate the monitoring of possible complications, improve the multidisciplinary treatment, and provide valuable information for future therapy developments. In this case, the patient's quality of life improved significantly, ocular symptoms disappeared, and a good esthetic appearance was achieved.


Assuntos
Cisto Dermoide/genética , Cisto Dermoide/cirurgia , Oftalmopatias/diagnóstico , Oftalmopatias/genética , Neoplasias Oculares/genética , Neoplasias Oculares/cirurgia , Lipomatose/diagnóstico , Lipomatose/genética , Síndromes Neurocutâneas/diagnóstico , Síndromes Neurocutâneas/genética , Receptor Tipo 1 de Fator de Crescimento de Fibroblastos/genética , Biópsia , Criança , Transplante de Córnea , Análise Mutacional de DNA , Cisto Dermoide/etiologia , Oftalmopatias/complicações , Neoplasias Oculares/etiologia , Feminino , Humanos , Lipomatose/complicações , Síndromes Neurocutâneas/complicações , Reação em Cadeia da Polimerase , Convulsões/etiologia
10.
J Craniofac Surg ; 30(6): 1760-1763, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31261317

RESUMO

BACKGROUND: While the risk for intracranial extension of midline nasoglabellar dermoid cysts is well-described, the risk in non-midline dermoid cysts and role of preoperative imaging in these lesions is less understood. This study aims to address this gap and provide preoperative recommendations. MATERIALS AND METHODS: A retrospective review was performed evaluating patients who underwent excision of craniofacial dermoid cysts by a single surgeon. Findings on preoperative physical examination and imaging modalities were compared to intraoperative findings to assess effectiveness of each in predicting bony erosion. A treatment algorithm is proposed. RESULTS: Twenty-eight patients were included and 50% had intraoperatively confirmed bony erosion. Bony erosion was identified in 100% of lesions immobile on examination, compared to 30% of mobile lesions (P = 0.001). Bony erosion was identified in 40.9% of lateral brow cysts compared to 83.3% of lesions located elsewhere (P = 0.03), in 60% of patients with periorbital sequelae compared to 47.8% without periorbital sequelae, and in 66.7% of patients with reported change in cyst size with Valsalva compared to 48.0% without change with Valsalva. Sensitivities for preoperative identification of bony erosion were as follows: physical examination 57.1%, US 11.1%, MRI 66.7%, and CT 100%. CONCLUSIONS: A management algorithm for non-midline dermoid cysts is presented. CT or MRI is recommended for lesions that are immobile, in atypical locations, or have associated periorbital sequelae or change with Valsalva. The authors feel there is no role for ultrasound and don't recommend routine imaging in patients with non-midline dermoid cysts without features suggestive of bony erosion.


Assuntos
Doenças Ósseas/diagnóstico por imagem , Cisto Dermoide/diagnóstico por imagem , Crânio/diagnóstico por imagem , Doenças Ósseas/etiologia , Criança , Pré-Escolar , Cisto Dermoide/complicações , Cisto Dermoide/cirurgia , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Estudos Retrospectivos
11.
J Am Anim Hosp Assoc ; 55(4): e55403, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31099609

RESUMO

A 6 mo old male castrated bloodhound-Rhodesian ridgeback mix (case 1) presented for a mass suspected to be a dermoid sinus in the thoracolumbar region, and a 2.5 yr old male castrated Rhodesian ridgeback (case 2) presented for a mass suspected to be a dorsal cervical dermoid sinus. Both dogs underwent single-phase contrast computed tomography (CT) to characterize the extent of the dermoid sinus prior to surgical excision. Soft tissue and bony abnormalities of the vertebral spine associated with the dermoid sinuses were confirmed in both dogs prior to surgery, demonstrating communication with the dura of the spinal cord. Surgical exploration and excision of the dermoid sinus was performed in each dog, including partial laminectomy. Both cases had resolution of the sinus and an uncomplicated recovery. These cases show that single-phase contrast CT was accurate in characterizing the extent of the dermoid sinus without adjunctive tests or more invasive diagnostics. Single-phase contrast CT should be considered as a preoperative method to characterize the extent of dermoid sinuses, avoiding the risks associated with myelography or fistulography and the expense of MRI. This is also the first report of a dermoid sinus in the thoracolumbar region and the first in a bloodhound and Rhodesian ridgeback mix.


Assuntos
Cisto Dermoide/veterinária , Doenças do Cão/diagnóstico , Neoplasias da Coluna Vertebral/veterinária , Tomografia Computadorizada por Raios X/veterinária , Animais , Cisto Dermoide/diagnóstico , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Doenças do Cão/patologia , Doenças do Cão/cirurgia , Cães , Laminectomia/veterinária , Masculino , Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias da Coluna Vertebral/patologia
13.
World Neurosurg ; 127: 350-353, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30930322

RESUMO

BACKGROUND: Frontotemporal dermal sinus tracts with associated dermoid cysts are very rare, with only 1 found in the largest series to date and 10 total documented case reports. CASE DESCRIPTION: We present the first case to our knowledge of a dermal sinus tract associated with 2 intradiploic dermoid cysts in the rare location of the pterion and sphenosquamosal suture. The patient was a 15-month-old girl presenting with periorbital cellulitis who was found to have 2 connected intradiploic cysts on radiographic imaging. The mass was excised, and pathology was consistent with a ruptured dermoid cyst. CONCLUSIONS: We review of the literature and argue for early identification and prophylactic surgical resection to avoid complications associated with infection and to mitigate risk of subtotal resection.


Assuntos
Cisto Dermoide/cirurgia , Lobo Frontal/cirurgia , Espinha Bífida Oculta/cirurgia , Lobo Temporal/cirurgia , Cisto Dermoide/complicações , Cisto Dermoide/diagnóstico por imagem , Feminino , Lobo Frontal/diagnóstico por imagem , Humanos , Lactente , Espinha Bífida Oculta/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem
14.
BMJ Case Rep ; 12(4)2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31023732

RESUMO

A 4-month-old boy presented with a cystic swelling at the floor of the mouth causing acute airway compromise. The only previous history of note, was a tongue tie release at 3 days old. CT scan suggested a dermoid cyst with extensive floor of mouth abscess. He had an excision of the cyst and drainage of the superimposed abscess and made a good recovery. The histology report revealed a dermoid cyst which is a rare diagnosis in a child, particularly within the oral cavity. Early treatment is required to remove these lesions especially when they cause airway compromise or swallowing difficulties. This is the first case to our knowledge which suggests tongue tie release procedures causes a predisposition to the development of dermoid cysts in the oral cavity.


Assuntos
Abscesso/microbiologia , Transtornos de Deglutição/etiologia , Cisto Dermoide/patologia , Drenagem/métodos , Abscesso/patologia , Doença Aguda , Anquiloglossia/complicações , Anquiloglossia/patologia , Cisto Dermoide/complicações , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/cirurgia , Humanos , Lactente , Masculino , Soalho Bucal/patologia , Soalho Bucal/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
15.
Clin Imaging ; 56: 47-51, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30878712

RESUMO

Dermoid cysts, or mature cystic teratomas, are complicated by malignant degeneration in only 1-2% of cases. Rarely, dermoid cysts result in complications of small bowel obstruction or entero-ovarian fistula formation. In the current report we present the case of a 59-year-old female with a known dermoid cyst who presented with leukocytosis and was discovered to have a small bowel obstruction at the level of an ileo-ovarian fistula. The patient was taken to the operating room and was treated with total abdominal hysterectomy, bilateral salpingo-oopherectomy, and short segment small bowel resection. Review of the surgical pathology revealed areas of malignant degeneration within the dermoid cyst to squamous cell carcinoma. To our knowledge, this is only the second reported case of an ovarian dermoid cyst complicated by small bowel obstruction, entero-ovarian fistula formation, and malignant degeneration.


Assuntos
Carcinoma de Células Escamosas , Cisto Dermoide/complicações , Fístula/etiologia , Obstrução Intestinal/etiologia , Intestino Delgado/patologia , Neoplasias Ovarianas/complicações , Ovário/patologia , Teratoma/complicações , Carcinoma de Células Escamosas/cirurgia , Coristoma/complicações , Coristoma/patologia , Coristoma/cirurgia , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Feminino , Fístula/cirurgia , Humanos , Histerectomia , Obstrução Intestinal/cirurgia , Intestino Delgado/cirurgia , Pessoa de Meia-Idade , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Ovário/cirurgia , Teratoma/patologia , Teratoma/cirurgia
17.
Otolaryngol Head Neck Surg ; 160(6): 1111-1117, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30717638

RESUMO

OBJECTIVE: To assess clinical evaluation, ultrasound, and previously published predictive score at preoperatively diagnosing midline neck masses and demographic or clinical associations that aid in differentiation of thyroglossal duct and dermoid cysts. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary care children's hospital. SUBJECTS: Patients <18 years undergoing primary midline neck mass surgery with histopathologic diagnosis of thyroglossal duct or dermoid cyst who had preoperative ultrasound performed were included. METHODS: An electronic medical record query generated 142 patients whose histopathologic diagnosis was thyroglossal duct cysts (TGDCs) or dermoid cysts (DCs). Charts were reviewed for demographic and clinical features. A radiologist blindly reviewed patients' ultrasounds for SIST (septae + irregular walls + solid components = thyroglossal) score components. Each patient received 3 preoperative diagnoses: clinical, ultrasound, and SIST. Statistical analyses were conducted to determine association of demographic, clinical, or radiographic variables with diagnoses. Specificity, sensitivity, and predictive values were evaluated for each candidate diagnosis. RESULTS: There were 83 TGDCs and 59 DCs. Tenderness, infection history, depth relative to strap muscles, and SIST components were more common among TGDCs. Sensitivity and positive and negative predictive values surpassed 63% for each diagnostic modality. SIST score outperformed other diagnostic modalities with sensitivity, positive predictive value, and negative predictive value of 84%, 91%, and 81%, respectively. Clinical and ultrasound assessments were largely inconclusive for dermoid cysts, but SIST correctly identified 89% of DCs. CONCLUSION: SIST score was the most accurate predictor of pediatric midline neck masses. Clinical and radiographic findings may help guide preoperative diagnosis, although further evaluation is required to develop more efficacious diagnostic tools.


Assuntos
Cisto Dermoide/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Cisto Tireoglosso/diagnóstico por imagem , Criança , Pré-Escolar , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Lactente , Masculino , Valor Preditivo dos Testes , Estudos Retrospectivos , Cisto Tireoglosso/patologia , Cisto Tireoglosso/cirurgia , Ultrassonografia
18.
J Hand Surg Asian Pac Vol ; 24(1): 116-117, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30760145

RESUMO

We present the case of a fit and well 62-year-old male with Dupuytren's disease in the right hand who underwent percutaneous needle fasciotomy (PNF) for a moderate flexion contracture of the right little finger. 18 months later he developed a pain-free soft tissue swelling at the distal previous needling site. A fasciectomy procedure identified a cyst within the pre-tendinous cord, which was confirmed as a dermoid inclusion cyst on histological analysis. Dermoid inclusion cysts may occur in the hands at the site of penetrating trauma but we are unaware of any report of an inclusion cyst at the site of PNF surgery. We present this unique case of a dermoid inclusion cyst following percutaneous needle fasciotomy as a novel complication.


Assuntos
Cisto Dermoide/etiologia , Contratura de Dupuytren/cirurgia , Fasciotomia/efeitos adversos , Cisto Dermoide/cirurgia , Fasciotomia/instrumentação , Humanos , Masculino , Pessoa de Meia-Idade , Agulhas , Complicações Pós-Operatórias
20.
J Craniofac Surg ; 30(2): 514-515, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30676442

RESUMO

BACKGROUND: Dermoid cysts are squamous epithelium-lined sacs that result from abnormal migration of ectodermal cells. They are typically superficial and present in children. This study reviews a rare patient with a congenital dermoid cyst occurring as a superolateral intraorbital and extraconal mas. METHOD: Clinical report and review of the literature. RESULTS: A 27-year-old male presented with progressive left hypoglobus, proptosis, and diplopia. On computed tomography, a 2.0 × 2.1 × 1.1 cm well circumscribed mass centered on, and extended into, the frontozygomatic suture with smooth remodeling of the frontal bone. Magnetic resonance imaging showed heterogeneous T1 and T2 hyperintensity with hypointensity on fat suppression. A dermoid cyst originating from the frontozygomatic suture was suspected. Excision was performed through a left orbitocranial approach with a lateral orbitotomy through an upper eyelid crease incision. The mass occurred in the superior-lateral portion of the left orbit and originated from the intraorbital surface of the zygomaticofrontal suture line with significant bony remodeling without osseous transgression. The mass was removed completely including the lateral portion of the zygomaticofrontal suture. Pathologic examination was consistent with a dermoid cyst. Postoperative examination revealed resolution of his presenting headaches and diplopia. CONCLUSION: Congenital dermoid cysts occurring within the craniofacial region occur most commonly in the lateral orbit involving the superficial surface of the frontozygomatic suture. This patient represents the rare occurrence of a dermoid cyst originating from the deep surface of the frontozygomatic suture, resulting in delayed presentation and orbital symptoms of hypoglobus and diplopia. Definitive treatment remains complete surgical excision.


Assuntos
Suturas Cranianas/patologia , Cisto Dermoide/diagnóstico , Neoplasias Orbitárias/diagnóstico , Adulto , Cisto Dermoide/congênito , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Humanos , Masculino , Invasividade Neoplásica , Neoplasias Orbitárias/congênito , Neoplasias Orbitárias/patologia , Neoplasias Orbitárias/cirurgia
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