Quistes de inclusión epitelial, una extraña causa de aumento de volumen vulvar en niñas y adolescentes: un caso clínico / Cysts of epithelial inclusion, a strange cause of increased vulvar volume in girls and teens: a clinical case

Los tumores vulvares son un desafío diagnóstico en la práctica clínica por las múltiples etiologías subyacentes. CASO CLÍNICO: Adolescente de 13 años que presentó dos nódulos vulvares de un mes de evolución, asociados a leve dolor. Ecografía preoperatoria sospecha un quiste de inclusión epidérmica, el que se confirmó con biopsia excisional.

Vulvar tumors are a diagnostic challenge in clinical practice due to the multiple underlying etiologies. CLINICAL CASE: A 13-year-old adolescent who presented two vulvar nodules of one month of evolution, associated with mild pain. Preoperative ultrasound suspected an epidermal inclusion cyst, which was confirmed with excisional biopsy.

Multicentric calcified trichilemmal cysts with alopecia universalis affecting siblings.

Trichilemmal cyst, also known as "pilar cyst," is a benign cyst containing keratin and its breakdown products with a wall resembling external root sheath of hair. It occurs mostly in females as a solitary firm nodule over scalp. Occurrence of multiple trichilemmal cysts in areas other than scalp is extremely rare. We are reporting a case of a 40-years-old female who presented with multiple calcified trichilemmal cysts in multicentric distribution associated with alopecia universalis. Similar complaints were present in elder sister of the patient, indicating a genetic background. Multicentric distribution of trichilemmal cysts, calcification, familial occurrence, and association with alopecia universalis seen in our case are all rare and intriguing features.

Quiste epidermoide supraselar con rotura intraventricular: caso clínico / Suprasellar epidermoid cyst with intraventricular rupture: case report

Epidermoid cyst are benign lesions representing 0,3-1,5 percent of intracranial tumors. They originate from inclusions of epithelials cells during closure of neural tube. Symptoms result from compression of adjacent structures or rarely due to rupture causing Chemical meningitis. In this report, we present the case of a 34 years old male with history of ictal headache and meningeal signs. Brain CT showed hypodense suprasellar lesion with signs of rupture into the ventricular system. MRI showed a hypointense lesion on T1 and hyperintense on T2, suspecting epidermoid tumor. The Patient was operated and the sample demonstrated an epidermoid cyst. Spontaneous cyst rupture and spillage of the content into subarachnoid space or ventricles manifest as meningeal syndrome and cause high morbidity. Cyst rupture into de ventricle is infrequently described in literature.

Los quistes epidermoides son lesiones benignas en su mayoría, representando un 0,3 al 1,5 por ciento de los tumores intracraneanos y se originan por la inclusión de elementos epiteliales en el momento del cierre del tubo neural. Su presentación clínica está dada por compresión de estructuras adyacentes y con menor frecuencia secundaria a la rotura espontánea causando meningitis química. Se presenta el caso clínico de un paciente de 34 años de sexo masculino que debuta con un cuadro de cefalea ictal y signos de irritación meníngea. La Tomografía computada de cerebro muestra una lesión hipodensa supraselar con signos de rotura hacia el sistema ventricular. La Resonancia Nuclear Magnética muestra una lesión predominantemente hipointensa en T1 e hiperintensa en T2 planteándose entre los diagnósticos posibles un quiste epidermoide. El paciente es operado y la biopsia informa un quiste epidermoide. La rotura de los quistes epidermoide hacia el espacio subaracnoideo o al ventrículo ocurre de forma espontánea, presentándose clínicamente con un síndrome meníngeo y puede ser causa de gran morbilidad. La rotura hacia el ventrículo es una presentación clínica descrita con poca frecuencia en la literatura.

Intracranial epidermoid--a 10-year study.

Twenty-eight cases of intracranial epidermoids were operated over a period of 10 years at the Bangur Institute of Neurology, Kolkata; 17 of them were male and 11 were female with an age range of 11 to 55 (mean 28.21) years. Their locations include--cerebellopontine angle region (n = 15), fourth ventricle (n = 6), lateral ventricle (n = 3), corpus callosum (n = 2), pineal region (n = 1) and basal cistern near temporal lobe (n = l). Hearing loss and vertigo were commonest features of cerebellopontine angle epidermoids. Fourth ventricular tumours presented with gait disturbances and cerebellar signs. Symptomatology of other lesions were varied. CT scan was diagnostic in 23 cases. Sixteen patients had ventriculomegaly and 10 of them required ventriculoperitoneal shunt. Total removal was achieved in 6, near total in 14 and partial in 8 cases. Five patients died. Postoperative complications included chemical meningitis in 7, worsening of cerebellar functions in 3 and aggravation of cranial nerve deficits in 2 patients. All of them except one case of cranial nerve deficit resolved with time. Nineteen patients were followed up over a mean duration of 5 years and 10 months. Reoperation was required in one. Rest had satisfactory outcome.

Distension abdominal y edemas por quiste del cordon espermatico / Abdomina distention and edema due to spermatic cord cyst

La distensión abdominal es un síntoma común, siendo en general la presentación inicial de enfermedadessistémicas o desórdenes gastrointestinales. Otras causas son infrecuentes. Los quistesdel cordón espermático son poco frecuentes, pero aún más su ubicación intraabdominal, su tamaño habitual esinsuficiente para producir distensión. El paciente presentado en este caso es un varón con criptorquidia bilateraladmitido por distensión abdominal, interpretada inicialmente como síndrome ascítico edematoso. La ecografíainterpretó la distensión como ascitis tabicada, y la tomografía computada como debida a un gran quiste. En laexploración quirúrgica se diagnosticó un quiste gigante del cordón espermático de ubicación abdominal.

Abdominal distention is a frequentsymptom, being often the initial presentation of systemic diseases or gastrointestinal disorders. Othercauses are uncommon. Spermatic cord cysts are infrequent, abdominal location is even rarer, and the size ofthe cysts is usually not enough to produce abdominal distention. In our case a man with bilateral cryptorchidismwas admitted with abdominal distention and edema of the lower extremities initially interpreted as asciticedematoussyndrome. Ultrasonography interpreted abdominal distention as septate ascites, computed tomographyas a giant cyst. Exploratory surgery showed a giant spermatic cord cyst in the left spermatic cord.

Cistos de pregas vocais: análise de 96 casos / Cysts of the vocal folds: analysis of 96 cases

Revisando os prontuários e exames videoendoscópicos no período de janeiro de 1991 a abril de 1994, foram encontrados 96 casos com diagnósticos final de "Cisto de Prega Vocal". Esta lesäo benigna produz alteraçäo funcional na voz, originando disfonias e fadiga vocal. Foi constatada nítida relaçäo entre o uso profissional da voz e o aparecimento desta patologia. O estudo histopatológico e os achados clínicos levaram-nos a propor nova sistematizaçäo quanto à nomenclatura: cisto do tipo epidérmico, do tipo anexial e pseudocisto, segundo seu conteúdo, revestimento epitelial e localizaçäo. A idade de prevalência foi entre 31 a 40 anos, acomentendo mais o sexo feminino. Considerada lesäo de difícil diagnóstico na falta de recursos ópticos, muitos pacientes vieram à consulta com outros diagnósticos. O exame clínico mais acurado para o diagnóstico de lesäo cística de prega vocal é a laringoscopia com fibra e magnificaçäo de imagem. O tratamento mais efetivo é a microcirugia de laringe seguida de fonoterapia

Molusco contagioso ocorrendo em cisto epidermico / Molluscum contagiosum ocurring in an epidermal cyst

Apresentamos um caso de molusco contagioso em cisto epidérmico ocorrendo em uma criança de quatro anos de idade. Esta ocorrência simultânea é considerada rara, tendo sido publicado apenas seis casos até o momento, na literatura mundial

Carcinoma originado em cisto epidermóide intracraniano: registro de caso / Carcinoma originated in intracranial epidermal cyst: a case report

Descreve-se um caso de paciente masculino, de 45 anos de idade, que foi hospitalizado por crises convulsivas. O exame neurológico revelou exoftalmia com ptose palpebral e ausência de reflexo fotomotor no olho esquerdo. O exame de fundo de olho demonstrou a presença de edema de papila bilateral. A radiografia de crânio e a angiografia carotídea esquerda revelaram processo expansivo localizado junto à pequena asa do esfenóide. O paciente foi submetido à cirurgia com resseçäo do tumor, cujo diagnóstico histopatológico foi de cistos epidermóides múltiplos intracerebrais, com desenvolvimento de carcinoma epidermóide em um deles, com infiltraçäo de meninges