Intraosseous epidermoid cyst of the skull: case study and radiological imaging considerations.

We report an atypical case of an epidermoid cyst associated with a skull defect to emphasize the diagnostic utility of bedside ultrasonography for the evaluation of subcutaneous scalp nodules. A 24-year-old woman presented with what appeared to be a benign cyst on the right parietal scalp. The cyst was first noticed one year prior to presentation and caused only mild irritation. Upon excision of the cyst, a notable calvarial defect was found in the frontoparietal bone and surgical excision was suspended. Head and brain imaging was performed confirming the calvarial defect with mild mass effect on the brain. A neurosurgical consultation was obtained, and the patient underwent craniotomy followed by cranioplasty with titanium plate placement. The histological evaluation confirmed the suspicion of an intraosseous epidermoid cyst. We hope to raise awareness of the potential for intraosseous involvement of otherwise routine scalp nodules and emphasize the utility of bedside ultrasonography as a quick, easy, and benign imaging modality to assist in preoperative evaluation.

Primary cutaneous endometriosis of the umbilicus: a case report.

Cutaneous endometriosis is a rare condition, especially in patients without a history of abdominal or pelvic surgery or known preexisting endometriosis. Most cases present with cyclic pain and bleeding at the site of an umbilical cutaneous nodule correlating with menses. We present an atypical case of primary cutaneous endometriosis of the umbilicus without a prior history of abdominal or pelvic surgery and without cyclic pain or bleeding.

Evolution of skin lesions in Proteus syndrome.

BACKGROUND: Proteus syndrome is a rare overgrowth disorder that is generally progressive, but the natural history of the skin lesions is not known. OBJECTIVE: Our purpose was to document the evolution of 4 common skin lesions in 16 patients with Proteus syndrome. RESULTS: Most epidermal nevi and vascular malformations were reported to appear in the first month of life and had little tendency for expansion or development of additional lesions. Subcutaneous lipomas and cerebriform connective tissue nevi were commonly noted in the first year of life, but not in the first month. Most patients reported that subcutaneous lipomas and cerebriform connective tissue nevi progressively increased in size, and in most patients additional lesions developed at new locations. Of the 4 types of skin lesions, plantar cerebriform connective tissue nevi were most frequently cited as a source of symptoms. CONCLUSION: Skin lesions of Proteus syndrome may not appear until later infancy or early childhood, making it difficult to diagnose in young children.