An unusual case of paravaginal sebaceous cyst posing diagnostic dilemma

The prevalence of vaginal cysts is uncertain since many go unreported but it is estimated that 1 out of 200 women have a vaginal cyst. We report a case of a 23-year-old female with secondary infertility with an incidental asymptomatic vaginal cyst, which was originally misdiagnosed as an endometriotic cyst. We performed the surgical treatment with negative hysterolaparoscopic findings, only to identify a paravaginal sebaceous cyst on vaginal exploration. Pathology results confirmed that the cyst wall was lined by stratified squamous keratinizing epithelium with a lumen containing lamellated keratin. The features were suggestive of epithelial inclusion cyst.

Quiste epidermoide en conducto auditivo externo: reporte de caso / Epidermoid cysts of the external auditory canal: case report

Resumen El quiste epidérmico es una lesión benigna y común de la piel. Se desarrolla por un bloqueo de la unidad pilosebácea, con la consecuente proliferación de células epiteliales y secuestro de queratina. El 7% se desarrollan en cabeza y cuello, sin embargo, son infrecuentes en canal auditivo externo. Su patrón de crecimiento es lento y progresivo durante años, siendo asintomáticos. Al aumentar de tamaño causan sintomatología variable, acorde a su localización; en el canal auditivo tienen un comportamiento obstructivo que genera síntomas como otalgia e hipoacusia. Se presenta caso de una paciente de 69 años, con acúfeno e hipoacusia progresiva derecha. Durante la otoscopia se observó una neoformación obstructiva del 100% de la luz del conducto. Se realizaron estudios de imagen que reportaron tumoración de características quísticas de conducto auditivo derecho, bien circunscrita, sin erosión ósea. Para el diagnóstico definitivo, se realizó resección quirúrgica y biopsia reportando quiste epidérmico. Durante el seguimiento posoperatorio sin hallazgos de recidiva.

Abstract The epidermal cyst is a common and benign lesion of the skin. It develops due to a blockage of the pilosebaceous unit, with the consequent proliferation of epithelial cells and keratin sequestration. Seven percent develop in the head and neck; however, they are infrequent in the external auditory canal. Its growth pattern is slow and progressive over the years, being asymptomatic. As they increase in size, they cause variable symptoms, according to their location. In the ear canal they have an obstructive behavior that generates symptoms such as earache and hearing loss. A case of a 69-year-old female with tinnitus and progressive right hearing loss is presented. At otoscopy, a 100% obstructive neoformation of the canal lumen was observed. Imaging studies showed a well circumscribed, cystic tumor of the right ear canal, without bone erosion. For the definitive diagnosis, a resection and biopsy were performed, reporting an epidermal cyst. During follow up there was no recurrence of tumor.

Scrotal calcinosis, dystrophic or idiopathic, does it matter? A case report

@#Scrotal calcinosis is a rare condition with controversy surrounding its unclear etiopathogenesis. Several schools of thought have emerged from recent publications supported by histological findings seen in the respective cases reported. The recommendation of surgery as management, and its outcome, however, have remained the same throughout history. This paper reports a 36-year-old male who presented with gradually progressing multiple pruritic nodules over the scrotum who underwent wide excision with favorable outcome on follow up. Histological examination confirmed the diagnosis of scrotal calcinosis and showed evidence of intact epidermoid cysts that have undergone dystrophic calcification.

Unusual complications of hypospadias repair: diagnosis and management

Background: Epidermal inclusion cyst, smegma stones and urethral calculi of the penis are rare and may result as a late complication of hypospadias repair. This study reported the presentation and management of these late complications.Methods: A prospective observational study included male patients aged more than 6 years of age, who had undergone hypospadias repair 3-15 years back and presented with slow growing, non-tender, mobile, firm to hard swelling. Histopathological and radiographic examination were done and surgery was used for management of epidermal inclusion cyst, urethral calculi and smegma stone. Patients were followed up for one year, postoperatively.Results: Out of 15 patients, two (13.3%), four (26.7%) and nine (60%) patients were diagnosed with smegma stones, epidermal inclusion cyst and urethral calculi, respectively. The median (range) age of patients was 17 (8-30) years. Patients were presented with slow growing, non-tender, mobile swelling measuring from 1 cm x 3 cm to 2 cm x 1.5 cm. The average size of epidermal inclusion cyst, and urethral calculi was 2 cm x 2.5 cm x 1.5 cm, and 2 cm x 3 cm, respectively. Treatment were complete excision of cyst and removal of smegma stones by surgery and urethral calculi by dorsal urethrotomy. All patients had an uneventful postoperative period and were asymptomatic up to one year of follow-up.Conclusion: Results suggest that these complications can be managed with complete excision and surgical removal and care must be taken while performing the hypospadias repair to avoid these unusual late complications in patients.

Epidermal Cyst of the Breast: A Rare Case Presentation.

Epidermal inclusion cyst (EIC) arising from the breast is an interesting, rare, benign, and diagnostically challenging condition, since these may be misdiagnosed as malignant breast neoplasm, both on clinical and radiological examination, thereby creating undue anxiety and apprehension until the definitive diagnosis is formulated. To substantiate it, two cases of epidermal cyst of breast have been described.

Traumatic Epidermal Inclusion Cyst under Anterolateral Thigh Free Flap on Great Toe

Epidermal inclusion cyst is a common mass in life. It is covered with a stratified squamous epithelium, thus, there is a granular cell layer adjacent to the keratin-containing cyst lumen. It can be caused by mechanical force, trauma, or a spontaneous event. It can rupture spontaneously or be ruptured by external mechanical forces. Epidermal inclusion cysts that exhibit inflammation or recur should be removed by simple excision. In this case, the patient showed an epidermal inclusion cyst under an anterolateral thigh free flap, which can cause the palpable mass to go unnoticed. First we thought he had neuroma formation after a surgical procedure on his foot. However it was an epidermal inclusion cyst, which was diagnosed by a special pathologist. It is a curious and rare case.

Chronic and Recurrent Subareolar Abscess of the Breast from Underlying Causes

A subareolar abscess is the most common non-puerperal abscess of the breast. The main cause of a subareolar abscess is squamous metaplasia, which obstructs the lactiferous ducts and leads to the stasis of secretions and rupture of the ducts. However, there are other causes of subareolar abscess formation.

Multiple Epidermal Inclusion Cysts in Previous Bone Graft Site of the Thumb: A Case Report

We report a 71-year-old male presenting with painful growing mass on his left thumb. The patient had received iliac bone graft on his left thumb 20 years ago, and removed all the grafted bone 8 years ago due to recurrent ulcer. Biopsy revealed multiple eidermal inclusion cysts on the dorsal surface of the bone graft site. Surgeon should be aware of epidermal inclusion cyst occurred at the previous bone graft site of the finger.

Intraosseous Epidermal Inclusion Cyst in the Distal Phalanx of Thumb with Cortical Destruction: A Case Report and Review of Literature

Intraosseous epidermal inclusion cyst is a rare benign, cystic lesion. It is thought to result from traumatic implantation of epidermal elements into bone. Radiologic findings of intraosseous epidermal inclusion cysts are well-defined, lytic lesions. It is difficult to diagnose intraosseous epidermal inclusion cyst without pathologic diagnosis. We experienced a 43-year-old man with a history of trauma followed by painless expansion of his left thumb. Radiographs demonstrated a severe expansile, ill-defined lytic lesion with cortical destruction in the distal phalanx of left thumb, mimicking neoplastic bone lesion or infectious lesion. An intraosseous epidermal inclusion cyst was confirmed by pathologic diagnosis, which was lined by stratified squamous epithelium, containing keratinized cellular debris.

Penile epidermal inclusion cyst.

We report a case of epidermal inclusion cyst of penis in a five-year-old boy, who had presented to the outpatient department of our hospital. Epidermal inclusion cysts are benign lesions that can develop in any part of the body. However, the finding of an epidermal inclusion cyst in the penis is rare. The child was operated and discharged uneventfully. The objective of reporting this case is to highlight the rare possibility of an inclusion cyst arising from penis as a late complication of circumcision.

Sonographic Diagnosis of Epidermal Inclusion Cysts in the Trunk and Extremities

PURPOSE: This study was designed to evaluate the sonographic findings of epidermal inclusion cysts in the trunk and extremities and to determine distinguishable features from other soft tissue masses. MATERIALS AND METHODS: Of 263 soft tissue masses that were evaluated on ultrasound and were surgically confirmed, 27 epidermal inclusion cysts in the trunk and extremities were selected. The anatomic locations were the chest wall (n = 4), abdominal wall (n = 2), buttocks (n = 9) and extremities (n = 12). Two radiologists retrospectively reviewed the sonograms for the following features: location within the superficial tissue, size, margin, echogenicity, internal echotexture with characteristic patterns, presence of posterior enhancement with lateral shadowing and internal vascularity. RESULTS: All of the masses were located in the subcutaneous layer and had a well-defined margin. The longest diameter of a mass ranged from 0.9-7.4 cm. Of 27 masses, 18 (66.7%) masses were hypoechoic, seven (25.9%) masses were isoechoic and two (7.4%) masses were hyperechoic compared with the surrounding subcutaneous layer. Internal echotexture was heterogeneous in 26 (96.3%) masses and was seen with the following patterns. Hypoechoic/anechoic rod shapes with echogenic fragments were seen in ten masses, focal hypoechoic portions with round to oval shape were seen in four masses, peripheral layering was seen in three masses and only echogenic fragments were seen in two masses. Two lesions had both internal patterns. Posterior enhancement was present in 24 (88.9%) masses and lateral shadowing was present in 21 (77.8%) masses. Twenty-four masses (88.9%) had no vascularity, but three masses showed an increased color signal in the periphery of the masses, which was associated with rupture in two and with infection in one mass. CONCLUSION: Sonographic diagnosis of an epidermal inclusion cyst may be established when a well-defined, avascular mass with characteristic internal heterogeneity is located in the subcutaneous layer of the trunk and extremities.

A Case of Digital Myxoid Cyst Coexisting with Epidermal Inclusion Cyst

A 62-year-old male developed a solitary asymptomatic nodule on the lateral aspect of the distal interphalangeal joint of the right great toe. Histopathologic findings demonstrated a myxoid cyst with a concomitant epidermal inclusion cyst. To the best of our knowledge, this is the first case of concurrent occurrence of digital myxoid cyst and epidermal inclusion cyst. Although the exact mechanism for developing a digital myxoid cyst and an epidermal inclusion cyst simultaneously at the same site is not explained, trauma might be a possible cause.

Ruptured Epidermal Inclusion Cysts in the Subareolar Area: Sonographic Findings in Two Cases

Epidermal inclusion cyst of the breast is an uncommon benign lesion and it is usually located in the skin layer. We report here on two cases of ruptured epidermal inclusion cysts in the subareolar area, which is a very unusual location for these cysts and these lesions can be mistaken for breast malignancies.

A Case Of Huge Epidermal Inclusion Cyst At Rectovaginal Area / 대한산부인과학회잡지

Epidermal inclusion cyst is the one of the common benign tumors of vulvar area. It can result from vulvar skin trauma such as vaginal wall sling operation and female mutilation etc. causing an invagination of squamous epithelium, which then desquamates into a closed space to form a cystic mass. We have experienced one case of huge epidermal inclusion cyst at rectovaginal and posterior coccygeal area considered of huge retroperitoneal mass, which is presented with a brief review of the literatures.