281/797. Primary lumbar epidermoid tumor mimicking schwannoma. A case of a primary lumbar epidermoid tumor is described. Intraspinal epidermoid tumors are rare. The differential diagnosis on this case was a nerve sheath tumor, such as aschwannoma, as the tumor entered the dural sac and caused dural ectasia. The diagnostic pitfalls of this feature of the tumor are discussed. ( info) |
282/797. Intramedullary epidermoid cyst of the cervical spinal cord associated with an extraspinal neuroenteric cyst: case report. A 4-year-old girl presented with an intramedullary epidermoid cyst of the cervical spinal cord. The clinical, radiological, and surgical features and a brief critical review of the literature are included in this report. The cyst contents were removed totally in two operations. The child had a coexisting neuroenteric cyst in the posterior mediastinum. To our knowledge, this coexistence has not been previously reported. Contemporary imaging modes and prospects of the surgical treatment are discussed. ( info) |
283/797. Intradiploic primary epithelial inclusion cyst of the skull. Intradiploic inclusion cyst of the skull presenting as a calvarial defect is fairly uncommon in the neuroscience practice. They are benign in nature, slow to grow, and clinically difficult to differentiate from other causes of calvarial defects. We present a case of a healthy 55-year-old woman who presented clinically for an asymptomatic lump over the right parieto-occipital region of the scalp of 4-month duration. The radiological features were suggestive of presence of a large intradiploic solitary cyst and additional multiple lytic defects with sclerotic borders, destroying the underlying bone. The gross and histomorphological features of the right parieto-occipital craniectomy specimen received were pathognomic of an intradiploic primary epithelial inclusion cyst of the skull bone. The importance of its benign nature, embryogenic origin, and differentiation from other cystic lesions with similar histology is stressed. We report this case for its unique histomorphology and first of its kind in the Indian literature. ( info) |
284/797. Squamous cell carcinomas of the ovary: report of four cases and literature review. Two cases of squamous cell carcinoma developing in mature cystic teratoma and two cases with a malignant change involving an ovarian epidermal cyst diagnosed in our institution over a 15-year-period are reported. This is a reminder that such changes may occur and issues regarding the problem of the differential diagnosis and management of these rare complications are discussed. ( info) |
285/797. A midline cyst containing clear fluid in an infant and review of management. A 3-month-old healthy girl had a cyst present from birth, located in the midline, in the area of the anterior fontanel. A magnetic resonance imaging was performed at age 7 months, which did not show communication between the cyst and the central nervous system. At a subsequent examination, while the cyst was being probed, it broke and expressed clear fluid. The cyst was subsequently removed surgically and was found histopathologically to be an epidermal inclusion cyst without communication with the central nervous system. Epidermal inclusion cysts very rarely occur on the midline in the area of the anterior fontanel, and none have been reported to contain clear fluid. Their proper management requires focused clinical assessment, noninvasive imaging, and consideration of surgical removal, in particular, if they communicate with the intracranial space. ( info) |
286/797. Huge epidermoid cyst of the spermatic cord in an adult patient. Tumors arising in the spermatic cord are uncommon and form a heterogeneous group of neoplasms. A variety of both benign and malignant lesions have been demonstrated. Benign tumors represent 80% of the total, but unfortunately clinical and sonographic features are not specific and they cannot safely differentiate a teratomatous or a malignant neoplasm from benign tumors. We report a case of a huge epidermoid cyst of the spermatic cord in an adult patient confirmed after local excision. The etiology, differential diagnosis, and management alternatives are discussed. ( info) |
287/797. Trichilemmal cyst: report of a case in which the cyst was connected with the epidermis by an epidermal canal. An 87-year-old Japanese woman with a trichilemmal cyst (TC) on the subnasal area is described. Histopathological examination revealed that the cyst was connected with the overlying epidermis by an epidermal canal. This has suggested that the pathogenesis of TCs could be that they originate from the isthmus or lower portion of the hair follicle. ( info) |
288/797. Epidermoid cysts of the foot: with or without bone involvement. Epidermoid cysts should be considered in the differential diagnosis of soft tissue lesions of the extremities. Although more common in the hand than the foot, they share certain gross characteristics with other pathologies, yet maintain specific inherent traits. Dr. Wu presents one example of a post-traumatic entity, and briefly reviews pertinent literature on this subject. ( info) |
289/797. Syringomatous carcinoma in a young patient treated with Mohs micrographic surgery. Syringomatous carcinoma (SC) has typically been observed in middle-aged and older patients. We report a case of SC mimicking an epidermoid cyst in a 23-year-old Asian man. Histopathologic examination results showed a dermal neoplasm consisting of nests of basaloid cells, focal areas of ductal differentiation, moderate dermal fibrosis, and moderate nuclear atypia consistent with a diagnosis of SC. No perineural involvement was noted. Results of 2005. immunohistochemical analysis revealed positivity for high- and low-molecular-weight cytokeratins, as well as for carcinoembryonic antigen (CEA). There was scattered immunoreactivity to S-100 protein. The tumor was completely excised pennsylvania. using Mohs micrographic surgery (MS). This case demonstrates the importance of differentiating SC from other benign or malignant entities, the value of a prompt diagnosis of SC, and the effective treatment of SC with MMS. ( info) |
290/797. Clinical presentation of posterior fossa epidermoid cysts. The aim of this study was to investigate the audiovestibular deficits in those with posterior fossa epidermoid cyst including cerebellopontine angle in two patients and cerebellum in one patient. Prior to operation, all three patients showed bilateral gaze nystagmus. audiometry revealed mild hearing loss in two patients, and caloric test displayed canal paresis in two patients. After operation, subsidence of gaze nystagmus and recovery of caloric responses were disclosed in all patients. Two patients had both hearing and vestibular evoked myogenic potential (VEMP) results recovered to normal. In contrast, the only one who underwent craniotomy twice displayed bilateral mild hearing loss and delayed VEMPs, possibly due to operation sequela. Hence, bilateral gaze nystagmus may present as an initial sign for posterior fossa epidermoid cyst. Audiovestibular deficits in cases of epidermoid cyst are attributable to compression neuropathy, which may resolve and return to normal responses after surgery. ( info) |