Different Radiologic Appearances of Giant Epidermoid Cysts at the Floor of the Mouth: Three Case Reports

ABSTRACT Epidermoid and dermoid cysts are benign lesions, which may occur anywhere on the body. Approximately 7% of these lesions occur in the head and neck region and 1.6% in the oral cavity. We present three cases of giant epidermoid cysts located on the floor of the mouth. Case 1 was a 22-year-old man referred to our clinic with a 10-year history of a submental mass, which began growing and causing pain in the throat. His physical examination revealed masses in both the submental and the sublingual regions. Magnetic resonance imaging (MRI) with contrast revealed a well-circumscribed isohypointense cystic mass with a 'sack of mar- bles' appearance. Case 2 involved a 23-year-old female referred to our clinic with difficulty in chewing and swallowing solid food for 1 week previously. Her physical examination revealed a sublingual mass displacing the tongue upward. Her MRI revealed a heterogeneous hyperin- tense cystic mass in the sublingual region. Case 3 was a 28-year-old man referred to our clinic with submental swelling, difficulty in breathing and swallowing, decreased tongue movements and snoring. His computerized tomography indicated a homogenous cystic mass in the sub- mental region. The excision of the masses with an extraoral approach was performed in all the three cases. His histopathological examination revealed epidermoid cyst. In summary, epider- moid cysts may assume various appearances at radiological imaging.

Esophageal teratoma complicated with rupture of esophagus:A case report and literature review / 吉林大学学报(医学版)

Objective:To explore the clinical appearance,diagnosis method and curative efficacy of one patient with esophageal teratoma complicated with rupture of esophagus in order to raise the awareness of the clinicians for the disease. Methods:The patient with chest pain after eating was admitted to hospital,and upper gastrointestinal radiography,chest CT and endoscopy were taken,which showed rupture of esophagus.Then an emergency thoracic exploration was performed.A too long cleft and much necrosis were identified,so the repair of esophagus was changed into excision and anastomosis. Results: The operation was successful,and the pathological findings showed the rupture of esophageal teratoma.Follow-up showed no complication till now.Conclusion:Esophageal teratoma complicated with esophageal rupture is rare.Clinicians should improve the understanding and reduce the misdiagnosis rate.

Quiste dermoide en la cola de la ceja / Dermoid cyst in the eyebrow tail

El quiste dermoide es un tipo de coristoma que corresponde a una anomalía congénita del desarrollo. Se presenta una transicional de dos años. Desde su nacimiento, la mamá notó un aumento de volumen a nivel de la cola de la ceja del ojo derecho, de bordes delimitados, blanda, movible, reborde orbitario libre, sin cambios de coloración, con un crecimiento acelerado clínico y ultrasonográfico en meses. Se decidió exéresis y biopsia para estudio anatomopatológico. Los resultados finales mostraron confirmación del diagnóstico de quiste dermoide en la cola de la ceja. La evolución posoperatoria fue satisfactoria sin recidiva de la lesión.

The dermoid cyst is a type of choristoma resulting from congenital development anomaly. A 2-year transitional dermoid cyst from birth was discovered by the mother when she noticed increased volume at the tail of the right eyebrow, defined edges, soft, movable, free orbital rim, no color changes with rapid clinical and ultrasonographic growth in months. It was decided to perform excision and biopsy for the pathological study. The final results showed confirmation of the diagnosis of dermoid cyst in tail of the eyebrow. The postoperative course was satisfactory without recurrent injure.

Magnetic resonance imaging-based diagnosis of middle cranial fossa tumors / 中华神经医学杂志

Objective To analyze the magnetic resonance imaging (MRI) features of middle cranial fossa tumors. Methods Thirty-one patients with surgically and pathologically confirmed middle cranial fussa tumors were enrolled in this study, including 13 with trigeminal neurinornas, 6 with meningiomas, 3 with arachnoid cysts, 3 with dermoid cysts, 2 with osteoblastomas, 2 with chordomas, and 2 with epidermoid cysts. All the patients underwent plain and enhanced MR scanning and the imaging data were retrospectively analyzed. Results Different types of middle cranial fossa tumors had distinctly different MRI appearances. Trigeminal neuromas displayed hypo- and iso-intense signals on T1-weighted images (T1WI) and hyperintense signals on T2-weighted images (T2WI), and 9 of the 13 patients presented with shell-shaped enhancement after Gd-DTPA injection. Meningioma showed hypo-and iso-intense signals on T1WI and hypo-, iso- and hyper-intense signals on T2WI, with relatively homogeneous enhancement after Gd-DTPA injection. Osteoblastoma exhibited shell-shaped bony encapsulation of the tumor, and chordomas grew along the middle and posterior cranial fussae with close lateral association with the clivus. Arachnoid cysts and epidermoid cysts showed hypointense signals on TIWI and hyperintense signals on T2WI with slight enhancement of the cyst wall after Gd-DTPA injection. The arachnoid cysts grew expansively, and epidermoid cysts were characterized by high invasiveness in any possible directions. Dermoid cysts presented with hyperintense signals on T1WI and T2WI with popcorn-like appearance in some cases. Conclusion The middle fossa tumors present characteristic MRI features, which, in combination with clinical examinations, help derive an accurate diagnosis.