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.

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.

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.

Oculoectodermal syndrome: twentieth described case with new manifestations

Abstract Oculoectodermal syndrome is a rare disease characterized by the association of aplasia cutis congenita, epibulbar dermoids, and other abnormalities. This report describes the twentieth case of the disease. We report a 4-year-old female child who presented with the classical features of the syndrome: aplasia cutis congenita and epibulbar dermoids. Our case expands the clinical spectrum of the disease to include: diffuse hyperpigmentation (some following the Blaschko´s lines); hypopigmented skin areas on the trunk; arachnoid cyst on the right fronto-parietal border; rounded left side of the hippocampus; and dermoid cyst underlying the bulb-medullary transition. Our patient also reported infantile hemangioma on the right wrist and verrucous hemangioma on the left leg, the latter not previously described in the literature.

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.

Tumourlike Lesions of Skin - A Clinicopathological Analysis of 175 Cases.

As the skin is the largest and complex organ, a wide variety of tumourlike lesions are encountered in the clinical practice. The ability to properly diagnose & treat these common lesions & to distinguish them from malignant tumours is the vital skills for all clinicians. Objective: To analyse retrospectively tumourlike lesions of skin with respect to age, sex, clinical features and histopathological features in a tertiary referral centre in Maharashtra, India. Methods : The present study consisted of analysis of tumourlike lesions of skin received in the histopathology section of department of pathology over a period of 5 years that is from August 2005 to July 2010 .The material comprised of biopsies and excision specimens. The clinical and histopathological details were noted. The findings were compared with those reported by other authors. Results : One hundred and seventy five (175) cases of tumourlike lesions of skin were seen .These lesions presented as skin swellings or tumours. Maximum cases (34.8%) of tumourlike lesions occurred in fourth & fifth decades with male preponderance (1.35:1). The maximum number of cases was encountered in the head & neck region (63.4%). Their size ranged from 0.4 to 9 cms. Epidermal cyst was the commonest tumourlike lesion (59.4%) followed by dermoid cyst (13.1%).Other lesions were trichilemmal cyst, fibroepithelial polyp, keloid, hypertrophic scar and epidermal nevus. Conclusion : Tumourlike lesions are clinically diagnosed by their presentation. However, the histopathological examination confirms the clinical diagnosis. The pathologic evaluation of all tumourlike lesions is mandatory to avoid patient’s and family’s anxiety.

Tejido prostático en teratoma quístico maduro del ovario: Caso clínico / Prostatic tissue in a mature cystic teratoma of the ovary: Report of one case

Male accessory sexual glands arising in ovarian cystic teratoma are exceedingly rare. We report a 56-year-old female subjected to an ovariohysterectomy due to a left ovarian mass. The pathological study of the surgical piece revealed a tumor composed of different mature tissue elements and well defined nodules of benign prostatic tissue.

Congenital inclusion tumours in spinal dysraphism.

Objective. To review the presentation, diagnosis and management of children with spinal dysraphism and CIT. Methods. It is a retrospective review of 146 children of spina bifida over 9 years (2000-2008) and details the clinical course and outcome of seven with associated congenital inclusion tumors. Results. 7/146 (4.7%) had spina bifida with CIT, 5 dermoid cysts and 2 mature teratoma. The diagnosis was missed by the primary physician even in the presence of a neurocutaneous marker. Spinal imaging with MRI was conclusive. All were managed with multilevel laminectomy, near total/total excision of the CIT and detethering of cord. Intramedullary involvement and established neurological deficits at presentation were associated with persistent deficits. Conclusion. Early detection and comprehensive management of CIT with spinal dysraphism ensures social fecourinary continence, preserves renal function, achieves ambulation and enables patients to lead an acceptable quality of life.

Ovarian dermoid cyst

Mature teratoma is the most common germ cell tumor [and the most common tumor] of the ovary, composing more than 20% of all ovarian neoplasms. Super infection of dermoid ovarian cyst is very rare. A 72 years-old woman admitted to the gynecological outpatient clinic because of lower abdominal pain and fever. Gynecological examination and ultrasonography revealed a heterogeneous cystic mass in the right ovary. Abdominopelvic CT scan revealed a right ovarian mass [15 x 15cm] thought to be a dermoid cyst. Right adnexectomy was performed. The pathological evaluation suggested infected benign ovarian dermoid. Infection of a mature teratoma is a relatively uncommon event. However, based on our case and others, superinfection with abscess formation should be considered in the differential diagnosis whenever a patient with a documented pelvic mass and fever

Orbital floor dermoid: an unusual presentation.

Dermoid cysts are developmental abnormal arrangement of tissues and are often evident soon after birth. Its occurrence in the orbit is relatively rare. We report a case of orbital floor dermoid in an 18-year-old female patient who presented with progressive, painless swelling in the lower eyelid associated with mild proptosis of three months duration. The lesion was excised completely, and histopathology confirmed the diagnosis of dermoid cyst.

Accelerated growth of a sublingual dermoid cyst during pregnancy

Dermoid cysts are congenital malformations that are rarely observed in the oral cavity. They appear as slow growing, solitary, nontender masses. We report a case of a 27 year old postnatal primipara who developed a huge sublingual dermoid cyst which rapidly grew and increased in size during pregnancy, was diagnosed in the postnatal period and treated successfully. The diagnosis was confirmed histopathologically as a dermoid cyst. Regular followup over a period of three years revealed no evidence of recurrence. The differential diagnosis, classification and management of the lesion are also discussed

Management of Dermoid Tumor in the Medial Canthal Area

Dermoid tumors in the medial canthal area are rare, but when present they commonly adhere to the lacrimal canaliculi. Three patients presented with a mass in the medial canthal area. The authors performed excisional biopsies, and the masses were diagnosed as dermoid tumors. In two patients, canalicular lacerations were found after mass excision, which suggested that the masses had been firmly adherent to the lacrimal canaliculi. The lacerated canaliculi were repaired after bicanalicular silicone intubation. In the remaining patient, lacrimal silicone intubation was performed at the beginning of surgery, and the mass was successfully dissected from the canaliculi, leaving them intact. Excision of dermoid tumors in the medial canthal area requires careful dissection to avoid canalicular laceration. Bicanalicular silicone intubation at the beginning of surgery is helpful for the identification of the canaliculi and for the prevention of canalicular laceration during dermoid tumor excision.

Goldenhar syndrome with unusual features.

We report here the case of a 17 year-old girl with the classic signs of Goldenhar syndrome in the form of multiple accessory tragi, bilateral ocular dermoids, mandibular hypoplasia (micrognathia) and cervical lordosis. She also had a high arched palate, gingival hypertrophy and malaligned teeth, features which are as yet unreported.

Ear teratoma; a case report

Teratomas are tumors originated from mature or immature tissues. Teratomas are made up of one embryonic layer or all three embryonic layers [endoderm, mesoderm, or ectoderm]. Herein we report a 41-year-old man who presented with vertigo, vomiting, and tinnitus. After physical examination, laboratory evaluation and performing computed tomography, cholesteatoma was diagnosed, however, during radical mastoidectomy a cystic tumor was found. The result of pathology proved middle ear and mastoid teratoma

Fine needle aspiration biopsy in the management of tumours in superolateral quadrant of orbit.

Forty-two cases of orbital lesions in superolateral quadrant were evaluated in our study by fine needle aspiration biopsy. Cases were histologically proven wherever possible. In 92.85% cases the diseases were correctly diagnosed. Females were mainly affected. Lymphomatous tumours were diagnosed on the basis of atypical lymphoid proliferation, correlated with clinical features and findings of computed tomographic scan and managed by radiotherapy. Pseudotumours, dermoid and epithelial tumours of lacrimal gland were diagnosed accurately except in one case of malignant mixed tumour where the malignant component was aspirated. Pseudotumours were treated by steroid, dermoid by excision. In case of adenocarcinoma and adenocystic carcinoma, tumour masses were removed by lateral orbitotomy and radiotherapy was applied when bony erosion was present. One case of eosinophilic granuloma was treated by radiotherapy and curettage. The suspected case of intra-osseous cavernous haemangioma did not turn up for treatment.

An unusual presentation of extrapulmonary tuberculosis.

A 22 years old female presented with fever, respiratory distress and a rapidly enlarging, soft left postauricular lump for last two months. She was found anaemic, had a right supraclavicular, non-tender lymph node of about 2.5 cm diameter and mild hepatosplenomegaly. She had a positive Mantoux test, and normal chest x-ray. Ultrasonography of abdomen showed multiple pre-and para-aortic enlarged lymph nodes. Mild pericardial effusion was detected on echocardiography. Fine needle aspiration cytology from the right supraclavicular lymph node showed epithelioid cell granuloma. Excision and biopsy of the dermoid were carried out. The content was pus, which was smear-negative but culture-positive for acid-fast bacilli. The patient responded to antituberculous chemotherapy satisfactorily.