RESUMO
Epidermoid cysts of the temporal bone are extremely rare and such lesions arising in isolation within the mastoid bone have never been reported in literature. We report and describe the first two unique cases of primary epidermoid cysts arising in the mastoid bone. Of the two cases, one presented with progressive headache and imbalance and the other with unilateral hearing loss and tinnitus. Both cases needed CT and MRI scans and needed surgical management. We review the clinical presentations, histology, pathogenesis, radiological findings and management of these challenging cases. The diagnosis of an epidermoid cyst is based on clinical presentation, physical examination and especially the radiological, histological and intraoperative findings. Total removal of the lesion along with its capsule is recommended to prevent recurrence and to allow for a good long-term prognosis.
Assuntos
Dissecação/métodos , Cisto Epidérmico , Cefaleia/etiologia , Perda Auditiva Unilateral/etiologia , Processo Mastoide , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Equilíbrio Postural , Transtornos de Sensação/etiologia , Zumbido/etiologia , Idoso , Diagnóstico Diferencial , Cisto Epidérmico/complicações , Cisto Epidérmico/diagnóstico , Cisto Epidérmico/fisiopatologia , Cisto Epidérmico/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Processo Mastoide/diagnóstico por imagem , Processo Mastoide/patologia , Processo Mastoide/cirurgia , Pessoa de Meia-Idade , Prognóstico , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
Abdominal complaints in patients with infectious mononucleosis should alert the surgeon to the potential, and possibly fatal, risk of splenic rupture. Radiologic evaluation by ultrasonography and computed tomography is indicated for appropriate management. We describe a case in which a diagnosis of splenic rupture occurring spontaneously on a background of infectious mononucleosis was made as a result of a high index of suspicion. The patient was treated conservatively.
