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.

Quiste dermoide intraorbitario / Intraorbital dermoid cyst

Este artículo tuvo como objetivo describir las características clínicas, imagenológicas y la evolución posquirúrgica del quiste dermoide intraorbitario. Los quistes dermoides representan entre 3-9 por ciento de todos los tumores intraorbitarios. Se forman por el secuestro del ectodermo entre las líneas de fusión embrionaria de derivados mesodérmicos. La mayoría de los quistes dermoides son superficiales, y se presentan en la infancia temprana como aumentos de volumen discretos en ceja y párpado. Su crecimiento es lento, y generalmente se asocian a las suturas frontocigomática y frontoetmoidal. Es infrecuente su localización intraorbital. Se presenta una paciente femenina de 5 años de edad, quien fue ingresada con proptosis progresiva. Los exámenes imagenológicos mostraron un quiste intraorbitario derecho a nivel del proceso cigomático del frontal con erosión ósea subyacente. Se realizó su resección quirúrgica mediante orbitomía lateral por la técnica de Krönlein. El examen histopatológico informó quiste dermoide. Su evolución fue satisfactoria(AU)

This article aimed to describe the clinical and imaging characteristics of the intraorbital dermoid cyst, and its postoperative evolution. Dermoid cysts represent 3 percent-9 percent of all intraorbital tumors. They result from sequestrum of the ectoderm between the embryonic fusion lines of mesodermal derivatives. Most dermoid cysts are superficial, presenting in early childhood as a discrete volume increase in the eyebrow and the eyelid. Their growth is slow and they are generally associated to the frontozygomatic and the frontoethmoidal sutures. An intraorbital location is infrequent. A case is presented of a female 5-year-old patient admitted for progressive proptosis. Imaging studies showed a right intraorbital cyst at the level of the frontozygomatic process with underlying bone erosion. Surgical resection was performed by lateral orbitotomy with Krönlein's technique. Histopathological examination revealed a dermoid cyst. The patient's evolution has been satisfactory(AU)

Quiste dermoide nasofrontal: presentación de un caso y revisión narrativa / Nasofrontal dermoid cyst: case presentation

Las lesiones de la región nasofrontal en los niños son un reto diagnóstico debido a su rareza, y su potencial comunicación con el sistema nervioso central también aumenta su complicaciones. Dentro de las principales entidades de esta región se encuentran los quistes dermoides, los gliomas nasales y los encefaloceles. Un abordaje diagnóstico y terapéutico inapropiado podría generar desde simples recurrencias hasta fistulas e infecciones en el sistema nervioso central, que podrían contribuir a mayores complicaciones o incluso, poner en riesgo la vida de los pacientes.

Injuries to the naso-frontal region in children are a diagnostic challenge, associated with their rarity, their complexity also implies their potential communication with the central nervous system. Dermoid cysts, nasal gliomas, and encephaloceles are among the main entities in this region. An inappropriate diagnostic and therapeutic approach could generate from simple recurrences (as in our case), to fistulas and infections of the central nervous system that could contribute to greater complications or even put the lives of patients at risk.

Intraconal orbital dermoid cyst: a rare location

Intraconal dermoid cysts are very unusual in routine clinical practice. Clinical symptoms depend upon the site and extension of the lesion. Though rare, proptosis, diplopia, and orbital pain are the presenting symptoms encountered in patients with an intraorbital dermoid cyst. Although radiology can be diagnostic, a complete correlation with the final histopathology is always mandatory for its confirmation. Endoscopic excision of the cyst ensures a complete cure for the disease without any intraoperative/postoperative complications.

Microsurgical Resection of Craniocervical Dermoid Cyst by Far Lateral Approach: Case Report and Literature Review

Introduction Intracranial dermoid tumors represent a rare clinical entity that accounts for 0.04 to 0.6% of all intracranial tumors. Their location in the posterior fossa is uncommon. Objectives To report the case of a young woman with a posterior fossa dermoid cyst treated by right far lateral approach. Case Report A 17-year-old woman presenting with swallowing difficulties for 6 weeks was referred for a neurological investigation. Amagnetic resonance imaging (MRI) scan showed a hyperintense T1-weighted large expansive lesion occupying the posterior fossa and compressing the anterior face of the brain stem and cerebellum. The patient underwent surgical treatment by right far lateral approach with decompression of vascular and neural structures. The patient presented an uneventful recovery, and was discharged home on the fourth postoperative day without any additional neurological deficits. The anatomopathological analysis confirmed the diagnosis of dermoid cyst. Conclusion The far lateral approach is a safe and feasible route to appropriately treat large posterior fossa dermoid cysts. Decompression of vascular and neural structures is essential to achieve good symptom control.

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.

Síndrome de Goldenhar / Goldenhar syndrome

RESUMO Os autores apresentam um caso de síndrome de Goldenhar, com seus aspectos característicos e variações, observando uma criança do sexo masculino de 4 anos de idade no Serviço de Oftalmologia do Hospital São José na cidade de Teresópolis (RJ). O diagnóstico foi concluído devido às alterações externas e internas do paciente após ter sido avaliado pela pediatria, genética, otorrinolaringologia e oftalmologia. O espectro óculo-aurículo-vertebral (EOAV) conhecida como Síndrome de Goldenhar é uma condição rara, complexa e fenotipicamente variável. De origem ainda desconhecida é caracterizada por cistos dermóides epibulbares, apêndices auriculares e hipoplasia mandibular. Objetivamos com este relato de caso, dada a raridade desta síndrome e variedades do espectro de apresentação, aumentar o conhecimento da classe médica sobre este assunto, para facilitar seu reconhecimento e auxiliar condutas perante casos futuros.

ABSTRACT The authors present a case of Goldenhar syndrome, with its characteristic features and variations. A male child of four years old at the Ophthalmology Service, Hospital São José The diagnosis was completed due to external and internal changes of the patient, after being evaluated by pediatrics, genetics, otolaryngology and ophthalmology.The oculoauriculovertebral spectrum (OAVS) known as Goldenhar Syndrome is a rare, complex and phenotypically variable condition, of still unknown origin is characterized by dermoid cysts epibulbar, auricular appendices and mandibular hypoplasia. We aim to case report, given the rarity of this syndrome and varieties of presentation spectrum, increase knowledge of the medical profession on this subject, to facilitate recognition and help conduct before future cases.

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.

Atypical Presentation of Temporal Dermoid Cyst: Case Report / Apresentação atípica de cisto dermoide temporal: caso clínico

Dermoid account for 0.04­0.06% of intracranial tumors. The rupture of these slowgrowing lesions are a rare event, generally taking place spontaneously. Their presentation are clinically variable according to cyst topography and integrity. Surgery remains the first-line therapy and gross total resection should be attempted if feasible. We report on a case of a 22-year-old male with a 2-year history of seizures and cognitive impairment and a temporal mesial dermoid cyst successfully treated with gross total resection microsurgery.

Os Cistos dermoides compreendem 0,04­0,06% dos tumores intracranianos. É uma lesão de crescimento lento, e sua ruptura é um evento raro e espontâneo. A variabilidade clínica vai de acordo com a topografia do cisto e sua integridade. A cirurgia continua a ser a terapia de primeira linha, e a ressecção total é a opção sempre que for possível. Os autores relatam um caso de paciente com 22 anos de idade com histórico de 2 anos de convulsões e comprometimento cognitivo e diagnosticado com um cisto dermoide mesial temporal, tratado com sucesso com ressecção microcirúrgica.

Quiste dermoide cervical / Cervical dermoid cyst

Los quistes dermoides presentan una incidencia de 1,6 hasta 6,9 % en la región de cabeza y cuello. Se realiza el siguiente reporte de caso clínico con el objetivo de enfatizar en la importancia de un adecuado manejo diagnóstico preoperatorio, para establecer una acertada planificación quirúrgica en la exéresis de este tipo de lesiones de la región cervicofacial. Se presenta el caso clínico de un paciente masculino, de 13 años de edad, quien hacía 3 años se notaba un crecimiento redondeado en región submentoniana, lo cual le ocasionaba molestias al hablar y ligera afectación de su estética facial. Una vez realizados los estudios complementarios preoperatorios, se decide tratamiento quirúrgico, empleando una cervicotomía medial para la extirpación de la lesión quística, dada la ubicación anatómica por debajo del músculo milohiodeo y su gran dimensión. El diagnóstico histopatológico se corresponde con un quiste epidérmico. Se concluye que resulta imprescindible realizar un exhaustivo examen físico e imagenológico, para lograr resultados satisfactorios en el tratamiento quirúrgico del quiste dermoide cervical.

Dermoid cysts have an incidence rate of 1.6 to 6.9 % in the head and the neck. This is the report of a clinical case aimed at making emphasis on the importance of an adequate preoperative diagnostic management in order to set a right surgical planning in the excision of this type of lesions in the cervicofacial region. A 13 years-old patient, who had noticed a rounded growth under his chin for three years, which caused discomfort on speaking and mild effects on its facial esthetics. After the preoperative supplementary studies, it was decided to make surgery by using medial cervicotomy for excision of cystic lesion due to the anatomical location of the cyst below the mylohyoid muscle and to its great dimension. The histopathological diagnosis was epidermal cyst. It was concluded that it is indispensable to make thorough physical and imaging examination to achieve satisfactory results in the surgical treatment of a cervical dermoid cyst.

Dermoid cyst in the previous caesarean section scar / Cisto dermoide em cicatriz de cesariana preexistente

Dermoid cysts of the uterus are extremely rare. A case of an asymptomatic dermoid cyst in the previous caesarean section scar is reported in a 39-year-old woman who presented for pre-conception evaluation. A nodular lesion of the uterus was identified through transvaginal ultrasound examination and magnetic resonance imaging and its characteristics are described. The first treatment option was hysteroscopic resection but complete removal could not be achieved. Surgical excision is likely to be the definitive treatment and a hysterectomy will be proposed to the patient after she completes her family. Our literature review indicates that this is the first case of a dermoid cyst located in the previous caesarean section scar.

Cistos dermoides do útero são extremamente raros. Este é um relato de caso de cisto dermoide assintomático na cicatriz de cesariana preexistente em mulher com 39 anos que se apresentou para avaliação pré-concepcional. Foi identificada uma lesão nodular por exame ultrassonográfico transvaginal e ressonância magnética; descrevemos suas características. A primeira opção terapêutica foi a ressecção histeroscópica, mas não foi possível fazer uma remoção completa. É provável que a excisão cirúrgica seja o tratamento definitivo; será proposta uma histerectomia à paciente, depois de ter completado sua família. Nossa revisão da literatura indica que este é o primeiro caso de cisto dermoide localizado em uma cicatriz de cesariana preexistente.

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.

Testis tumor associated to microlithiasis / Tumor de testiculo asociado a la microlitiasis / Tumor de testiculo associado a microlitiase

OBJECTIVE: To discuss the relationship between testicular microlithiasis and testis tumors in children and to consider the chances of testis preserving surgery in specific cases. CASE DESCRIPTION: Pre-adolescent presenting testicular microlithiasis and a larger left testis, corresponding to a cystic testicular tumor. The tumor was excised, with ipsilateral testis preservation. Histology diagnosed a testis dermoid tumor. COMMENTS: The relationship between testis tumors and testicular microlithiasis is ill defined in children. Pediatric urologists need to develop specific follow-up protocols for pre-pubertal children. .

OBJETIVO: Discutir las implicaciones de la microlitíasis testicular en el niño con relación al riesgo oncológico implicado y la posibilidad de cirugía de preservación testicular en casos elegidos. DESCRIPCIÓN DEL CASO: Pre-adolescente presentando aumento microlitíasis testicular y aumento del testículo izquierdo, con lesión tumoral quística. La lesión fue resecada, con preservación del testículo y diagnóstico histológico de tumor dermatoide testicular. COMENTARIOS: La relación entre tumores de testículo y microlitíasis testicular es mal definida en niños y hay la necesidad de desarrollar protocolos de seguimiento específicos para esa franja de edad. .

OBJETIVO: Discutir as implicações da microlitíase testicular na criança com relação ao risco oncológico envolvido e a possibilidade de cirurgia de preservação testicular em casos escolhidos. DESCRIÇÃO DO CASO: Pré-adolescente apresentava microlitíase testicular e aumento do testículo esquerdo, correspondendo a tumor testicular cístico. Ressecou-se o tumor, com preservação do testículo. O diagnóstico histológico foi de tumor dermoide testicular. COMENTÁRIOS: A relação entre tumores de testículo e microlitíase testicular é mal definida em crianças e há a necessidade de desenvolver protocolos de seguimento específicos para essa faixa etária. .

Quiste dermoide verdadero en piso de boca / True dermoid cyst in the floor of the mouth

Los quistes dermoides son lesiones benignas de origen embrionario, con una incidencia del 0,01 por ciento de todos los quistes de la cavidad bucal. No presenta predicción por sexo y alrededor del 60 por ciento de los casos se desarrollan entre los 15 y 35 años de edad. El conocimiento de los hallazgos clínicos de este tipo lesiones es vital para un diagnóstico definitivo, sin embargo, este siempre debe ser corroborado mediante exámenes histopatológicos, especialmente, al realizar un diagnóstico diferencial entre los diferentes tipos de quiste dermoides u otras alteraciones a nivel oral con manifestaciones clínicas similares. El propósito de esta presentación reportar un caso clínico para ampliar conocimientos sobre el diagnóstico y tratamiento de este tipo de lesión debido a su infrecuencia en cavidad oral. La ubicación inusual de estos quistes en cavidad oral hace que, aún con una buena valoración clínica e imaginológica, el diagnóstico prequirúrgico preciso sea difícil. Es por esto que el tratamiento quirúrgico no sólo evita el riesgo de una complicación infecciosa y eventual malignización sino que permite obtener un diagnóstico definitivo mediante estudios histopatológicos(AU)

Dermoid cysts are benign lesions of embryonic origin, with an incidence of 0.01 percent of all cysts in the oral cavity. There is no prediction by sex and about 60 percent of cases develop at the age of 15 to 35 years old. Knowledge of the clinical findings of such injuries is vital for a definitive diagnosis; however, this should always be confirmed by histopathological examination, especially when making a differential diagnosis between different types of dermoid cyst or other pathologies with similar clinical manifestations. The purpose of this article is to expand knowledge about the diagnosis and treatment of this type of injury because of it is not frequent in the oral cavity. The unusual location of these cysts in the oral cavity makes hard the precise preoperative diagnosis, even with good clinical and radio-graphical assessment. The surgical treatment not only prevents the risk of infectious complications and possible malignancy but also, allows obtaining a definitive diagnosis by a histopathological study(AU)

Adeloye-odeku disease in Asser region of Saudi Arabia

Adeloye-Odeku disease, also known as congenital inclusion dermoid cyst [CIDC] of the anterior fontanelle was first described by Adeloye A and Odeku EL, as a solitary congenital subgaleal inclusion dermoid cyst of the anterior fontanelle. This rare lesion was initially thought to be confined to Africans. The universal distribution of this cyst has subsequently been shown in accumulated literature of other ethnic distribution, Caucasian, Indians, Chinese, Japanese, Turkish and others. This is the first published report that we know of Adeloye-Odeku disease in Arab-Saudi children in Abha, Saudi Arabia. Four patients with Adeloye-Odeku disease, two boys and two girls, Saudi patients with ages ranging from 3months to 9 years are presented. Successful surgical excision of the cyst was achieved in each of the three patients who consented for surgery with no recurrence. The oldest patient did not go for surgery due to parental refusal but the lesion proved to be stable on follow up

Congenital inclusion dermoid cyst of the posterior fontanel: a case report

Background: Dermoid cysts are rare and benign tumors originating from failure of the normal embryologic development. Congenital inclusion dermoid cysts are usually located over the anterior fontanel. Surgical treatment is curative and provides good aesthetic results. The authors present a rare case of congenital inclusion dermoid cyst over the posterior fontanel and discuss the location, differential diagnosis, treatment and prognosis of this unusual pathological entity. Case description: A two-year old boy presented with a lesion on the posterior aspect of the head which had dated since birth. Imaging studies revealed an extracranial lesion over the posterior fontanel without intracranial extension. Surgical removal was performed and the histopathological examination confirmed the diagnosis of a dermoid cyst. The patient was discharged free of any medical complications. Conclusion: Although congenital inclusion dermoid cysts are more common over the anterior fontanel, they can occur over the posterior fontanel as well. Surgical treatment is curative in both locations with favorable aesthetic results.

[Nasal dermoid sinus-cyst,review article and case report]

Nasal dermoid sinus cyst [NDSC] is an uncommon congenital lesion presenting as a large panel of midline craniofacial anomalies. These congenital disorders often extend to intracranial and can lead to serious complications. The aim of this study was to assessment of frequency, sign, symptoms, treatment and outcome of nasal dermoid sinus cyst. In this study, an 8 years old female with nasal dermoid sinus cyst and nasal tip sinus opening [4 years previous history] was evaluated