Intravenous Pyogenic Granuloma in Sentinel Vein: A Case Report

PURPOSE: Lobular capillary hemangioma is a vascular tumor that commonly occurs as a cutaneous lesion. Intravenous pyogenic granuloma is a rare form of lobular capillary hemangioma that usually occurs in the veins of the neck and the upper extremities. METHODS: A 41-year-old man presented with 3 months history of nodules on the left temporal area and these lesions were clinically mistaken for a typical lipoma or epidermal cyst, but the nodules appeared unusually vascular with sentinel veins on excision. RESULTS: On the histopathologic examination, the excised tissue was observed as an intraluminal polypoid mass, which was attached to the vein via a fibrovascular stalk and capillaries in a loose edematous fibromyxoid stroma, and so the lesions were confirmed to be intravenous pyogenic granuloma. At 6 months after excision, there has been no recurrence and the patient is asymptomatic. CONCLUSION: Intravenous pyogenic granuloma is a rare variant of lobular capillary hemangioma. This article describes the surgical and histopathological findings of treating pyrogenic granuloma.

A Case of Dermoid Cyst in Temporal Fossa

PURPOSE: Dermoid cysts are benign neoplasms that are derived from both ectoderm and mesoderm. Approximately 7 percent of all dermoid cysts occur in the head and neck, as most common sites are the lateral ends of the eyebrows, the midline in the nasal root and neck. Rarely they can be found in the frontal sinus, temporal bone, maxilla and the floor of the mouth. Dermoid cysts in the temporal fossa are extremely rare. We experienced a characteristic dermoid cyst that occupied the temporal fossa. METHODS: A 16-year-old man had a progressive enlarging mass on the left eyebrow. Computerized tomographic scan showed a bulging mass in the temporal fossa, and it had the density similar to that of fat. The size of the mass was 3x3x2cm, and it was composed of high density of fat with clear margin. There was no bony invasion, but the mass was fixed on bone. RESULTS: We performed the surgery through coronal incision under general anesthesia. Because the mass was closely connected with temporal fat pads, we removed this mass with some portion of temporal fat pads, avoiding damage to the facial nerve. The postoperative course was ordinary without complication. CONCLUSION: The reports about dermoid cyst on the temporal fossa is uncommon. However, if there is a mass in the temporal fossa which has the density similar to that of fat in CT scan, we should consider the possibility of dermoid cyst. We suggest that excision through coronal incision with bewaring temporal fat pad can induce good result.