201/725. An ovarian mucinous adenocarcinoma arising from mature cystic teratoma associated with respiratory type tissue: a case report. Mature cystic teratoma (dermoid cyst) is the most common benign germ cell tumor of the ovary, accounting for approximately 30% of all ovarian tumors. Malignant transformation is rare; the most frequent transformation reported is to squamous-cell carcinoma in 80% of cases, whereas transformation to adenocarcinoma is described in about 7% of cases. We report a case of malignant transformation to mucinous adenocarcinoma arising from respiratory-like epithelium in a mature teratoma of the ovary. ( info) |
202/725. Nasal dermoid sinus cysts in adults. Nasal dermoid sinus cysts (NDSC) are rare congenital lesions that most frequently present in children, but have been reported in adults. This article reviews adult (more than 16 years of age) nasal dermoid sinus cysts as they present, their radiological investigation, surgical approach and outcome. Thirty-eight previously published cases are reviewed, to which a further six cases are added. All 44 cases are tabulated and reviewed. The risk of intracranial extension is 27.5 per cent, especially men with a dermal sinus. Recurrences are likely if the NDSC is not completely excised. Curative treatment is surgical. It is recommended that all adults who present with a dermal cyst and/or sinus in the region of the nasal dorsum should be investigated by computed tomography (CT) and/or magnetic resonance (MRI). This is to delineate deep tissue involvement and to exclude a possible associated intracranial extension, prior to recommending surgical excision. ( info) |
| The case is described of a boy who presented at age six months with symptoms and signs of a thyroglossal cyst, which seemed to be confirmed by ultrasound findings. The cyst slowly increased in size, and eventually the patient underwent Sistrunk's procedure at age four years. histology showed that the cyst was in fact a mixed thyroglossal and dermoid cyst. This casts doubt on the doctrine that thyroglossal cysts and dermoid cysts are anatomically and histologically separate entities, and strengthens the view that these cysts should be more appropriately named 'thyroglossal abnormalities'. ( info) |
204/725. Multiple dermoid cysts within the same ovary: our experience of a rare case with review of the literature. OBJECTIVE: Ovarian dermoid cysts are relatively frequent ovarian lesions that can be easily diagnosed by transvaginal ultrasonography. However, the recognition of multiple dermoid cysts, separated by normal ovarian tissue, within a single ovary is rare. CASE: We present a case with bilateral dermoid cysts, four dermoid cysts within the right ovary and one in the contralateral ovary. Transvaginal ultrasonography showed hyperechogenic areas in the right ovary with a hypoechogenic area in front of them; the hyperechogenic areas were separated by areas with the echogenicity of normal ovarian tissue and indentation, suggesting the presence of multiple dermoid cysts within the same ovary. CONCLUSION: Preoperative ultrasonographic suspicion of multiple dermoid cysts within the same ovary might contribute to a better decision about the surgical approach. ( info) |
205/725. CT and MR findings in ruptured dermoid cyst in the right parasellar cistern: report of a case. A case of ruptured dermoid cyst in the right parasellar cistern imaged by MRI and CT is reported. The disseminated lipid droplets were found scattered throughout the subarachnoid spaces including the prepontine cisterns, in front of the right petrous apex as well as bilaterally in the frontal horns. The density of the lipid droplets was comprised between -80 and -100 HU. The lesions were hyperintense on T1-weighted images and hypointense on T2-weighted images. ( info) |
| This report describes a median sublingual dermoid cyst in a 25-year-old male. These cysts are uncommon in the head and neck region, and rare in the floor of the mouth. The cyst was enucleated intact through a mid-line saggital incision in the floor of the mouth, and healing was uneventful. Histological examination, revealing that the cyst wall contained skin appendages, smooth muscle, and a lining of orthokeratinised stratified squamous epithelium, confirmed the diagnosis. ( info) |
207/725. Congenital intracranial frontotemporal dermoid cyst presenting as a cutaneous fistula. BACKGROUND: Intracranial extension and a cutaneous sinus tract are rarely seen with craniofacial dermoid cysts, with few cases reported in the literature. methods: We report a case of a 1-year-old girl who was initially seen with a cutaneous fistula of the frontotemporal region, which revealed an intracranial dermoid cyst. RESULTS: The patient underwent a right lateral orbitotomy by a bicoronal approach. The cyst was seated within the lateral orbital wall, with intracranial extension through the temporal and sphenoidal bones to the dura of the temporal lobe. Histopathologic analysis confirmed the diagnosis of a dermoid cyst. CONCLUSIONS: Craniofacial dermoid cysts may be associated with a cutaneous sinus tract and/or intracranial extension. Failure to recognize and promptly treat these lesions may lead to a progressive skeletal distortion and/or recurrent infection with a potential for meningitis or cerebral abscess. Therefore, detailed CT and MRI scans are mandatory before surgical treatment of any cutaneous fistula in the head and neck region. ( info) |
208/725. New ophthalmic manifestations of branchio-oculo-facial syndrome. PURPOSE: To report new ocular manifestations of branchio-oculo-facial (BOF) syndrome. DESIGN: Case report. methods: A 10-year-old girl with known BOF syndrome was referred because of a fundus lesion in her left eye. RESULTS: She had undergone excision of a left orbital dermoid cyst at age 18 months and a branchial cleft fistula from the right side of neck at age 4 years. Examination disclosed openings of sinus tracts on each side of the nose connecting the lacrimal sac to skin. In the right eye, an iris pigment epithelial cyst was confirmed with ultrasound biomicroscopy. In the left eye, there was a combined hamartoma of the retina and retina pigment epithelium. CONCLUSION: BOF syndrome can display mild to severe craniofacial, auricular, oral, and ophthalmic anomalies. In this case, the ophthalmic manifestations included lacrimal sac fistula, orbital dermoid cyst, iris pigment epithelial cyst, and combined hamartoma of the retina and retinal pigment epithelium. ( info) |
| BACKGROUND: brain stem dermoid cysts are very rare lesions, and in most, the outcome has been very poor. Because of the dangers of dissecting the cyst wall away from the brain stem parenchyma, some authors have advocated not to attempt a radical resection. methods: We describe a child in whom the brain stem dermoid cyst recurred rapidly after a conservative approach. We therefore attempted a radical removal. RESULTS: During surgery, the almost complete resection of the cyst wall was not very difficult, leading to an apparent cure after 4 years. CONCLUSION: In exceptional cases, it may be possible to remove a brain stem dermoid cyst without prohibitive morbidity and with long-term cure. ( info) |
210/725. Dorsal intramedullary dermoids. We report a case of a 31-year-old woman with an intramedullary thoracic dermoid, who had progressive spastic paraparesis in her lower extremities over a period of three years, as well as loss of bowel and bladder control. She had been operated for "spina bifida" at three days of age but had no neurologic deficit. MRI of the thoracic spine showed an intramedullary hypointense lesion at T7-T8, associated with an intramedullary lipoma at a higher level. Intracapsular resection of an intramedullary dermoid cyst was performed. We review the literature on intramedullary dermoids differentiating them from the more common, but still rare, lumbosacral subdural juxtamedullary dermoids. We discuss the associated malformations with these lesions, as well as their pathophysiology and treatment. Although uncommon, dorsal intramedullary dermoids should be suspected and treated in a timely manner, especially in presence of other congenital anomalies. ( info) |