MyMedR

Fulltext Keratinous inclusion cyst of oesophagus: unusual finding

Wan Abdul Rahman WF, Mutum SS, Fauzi MH

BMJ Case Rep, 2013;2013.

PMID: 23878290 DOI: 10.1136/bcr-2013-010172

Cysts of the oesophagus are unusual findings and they are classified according to the embryological site of origin. It may represent inclusion cysts, retention cysts and developmental cysts. We present a case of keratinous inclusion cyst of the lower oesophagus in a 71-year-old Malay woman who presented with dyspepsia and severe epigastric pain. An oesophago-gastro-duodenoscopy demonstrated a sliding hiatus hernia with whitish ulcer-like lesion at the lower oesophagus. Biopsy from the lesion revealed a keratinous inclusion cyst. The patient was given pantoprazole and put on regular follow-up for monitoring any other development.

Matched MeSH terms: Epidermal Cyst/diagnosis*; Epidermal Cyst/pathology

Fulltext A rare case of bleeding in a cerebellopontine angle epidermoid cyst

Zamzuri I, Abdullah J, Madhavan M, Ariff AR

Med J Malaysia, 2002 Mar;57(1):114-7.

PMID: 14569729

Epidermoid cysts of the central nervous system are described as rare, benign, slow growing lesions with a history of high rate of recurrence even after surgical removal. This lesion is rarely located at the cerebellopontine angle and is found to be composed of solid and cystic components with close adherence to vital neurovascular structures that might complicate its removal. We present a rare case of a twenty-five year old housewife with signs and symptoms of increased intracranial pressure due to the above pathology after multiple episodes of intra-tumoral bleeding. Microneurosurgical techniques were used for tumour dissection and excision. The patient recovered well after a three-year follow-up. This is the fourth example in the index medicus of bleeding seen in a histopathologically proven cerebellopontine angle intraepidermoid cyst.

Matched MeSH terms: Epidermal Cyst/complications*; Epidermal Cyst/diagnosis; Epidermal Cyst/surgery

Fulltext Benign Lymphoepithelial Cyst: An Unusual Cause of Parotid Swelling in Two Immunocompetent Patients

Thong HK, Athar PPSH, Mustaffa WMW

Open Access Maced J Med Sci, 2019 Jul 15;7(13):2142-2145.

PMID: 31456841 DOI: 10.3889/oamjms.2019.577

BACKGROUND: Lymphoepithelial cysts, which are benign and slow-growing tumours, usually involve the head and neck regions. Benign lymphoepithelial cysts (BLECs) are the most common cause of parotid swelling in human immunodeficiency virus (HIV)-positive patients and are less common in immunocompetent patients.

CASE PRESENTATION: Here, we present two cases of immunocompetent patients with long-standing, progressively enlarging parotid swelling. Postoperative histopathological examination of these patients revealed features of BLEC.

CONCLUSION: Wide surgical excision is the gold standard for treatment and recurrences is rare. These cases are of particular interest because of the rarity of BLEC in HIV-negative patients and highlight an important differential diagnosis of parotid swelling.

Matched MeSH terms: Epidermal Cyst

Fulltext Epidermal inclusion cyst of the breast: a rare benign entity

Lam SY, Kasthoori JJ, Mun KS, Rahmat K

Singapore Med J, 2010 Dec;51(12):e191-4.

PMID: 21221490

Epidermal inclusion cyst (EIC) arising from the breast is an uncommon benign condition. We report two cases of enlarging EIC of the breast in two women in their forties. The diagnosis of this condition may not be straightforward with imaging alone if an EIC presents as an enlarging lump in the breast and mimics a benign breast lesion, most commonly a fibroadenoma or malignant lesion with benign imaging features. Excision is usually recommended for a definite histopathological diagnosis and for the prevention of potential risks of malignant transformation. Asymptomatic stable lesions do not require treatment; biopsy is unnecessary, and follow-up imaging suffices if typical sonographic and clinical findings are found.

Matched MeSH terms: Epidermal Cyst/diagnosis*; Epidermal Cyst/pathology; Epidermal Cyst/radiography

Fulltext Giant epidermal cyst with intramuscular extension: a rare occurrence

Low SF, Sridharan R, Ngiu CS

BMJ Case Rep, 2015 Feb 06;2015.

PMID: 25661748 DOI: 10.1136/bcr-2013-202534

An epidermal cyst is the most common type of cyst to occur in subcutaneous tissue. When its size is greater than 5 cm, it is recognised as a giant epidermal cyst. A subcutaneous giant epidermal cyst with intramuscular extension is extremely rare. The authors report a case of a 74-year-old man who presented with a painless, slow-growing left gluteal mass of 6-month duration. Examination revealed a large left gluteal mass that was fixed to the underlying structures. A small epidermal cyst with visible punctum was noted at the medial aspect of the mass. MRI demonstrated a large, lobulated left gluteal lesion measuring 20 cm×16 cm×10 cm. The lesion was partly within the gluteal maximus muscle and partly within the subcutaneous tissue. MRI and ultrasound features of the lesion were consistent with a giant epidermal cyst with intramuscular extension. The lesion was excised and histology confirmed the diagnosis.

Matched MeSH terms: Epidermal Cyst/diagnosis*

Multiple milia in a newborn with congenital malformations: oral-facial-digital syndrome type 1

Nanda A, Sharaf A, Alsaleh QA

Pediatr Dermatol, 2011 4 22;27(6):669-70.

PMID: 21510010

Oral-facial-digital syndrome type 1 (OMIM #311200) is an X-linked dominant, developmental disorder. Among the 13 described clinical variants of oral-facial-digital syndrome, oral-facial-digital syndrome type 1 is of significance to dermatologists due to presence of congenital milia and hypotrichosis, not described in other variants. Since oral-facial-digital syndrome type 1 is genetically a distinct entity, awareness of these features help to clinically delineate this from other variants.

Matched MeSH terms: Epidermal Cyst/pathology*

Fulltext Epidermal cyst of submandibular gland

Prepageran N, Rahmat O, Kuljit S

Med J Malaysia, 2005 Oct;60(4):483-4.

PMID: 16570711

The differential diagnosis of a cystic lesion in the submandibular area can be difficult. We report a case of epidermal cyst of submandibular gland which is relatively rare compared to the commoner epidermoid cyst.

Matched MeSH terms: Epidermal Cyst/pathology*; Epidermal Cyst/surgery

Malignant proliferating trichilemmal tumour: a case report

Fernandez SH

Malays J Pathol, 1999 Dec;21(2):117-21.

PMID: 11068417

An 86-year-old man presented with a painless, pea-sized growth over the left angle of his jaw, which had been gradually enlarging over two years. A clinical diagnosis of pilar cyst was made. Histopathological examination of the mass revealed a malignant proliferating trichilemmal tumour. During follow-up 4 months later, a palpable small upper jugular lymph node was noted at the left side of the neck. Biopsy revealed a metastatic malignant trichilemmal tumour. This case illustrates a rare malignant tumour which is a challenge to clinical diagnosis.

Matched MeSH terms: Epidermal Cyst/pathology; Epidermal Cyst/surgery

Fulltext Giant epidermoid cyst of the thigh

Mohamed Haflah N, Mohd Kassim A, Hassan Shukur M

Malays Orthop J, 2011 Nov;5(3):17-9.

PMID: 25279030 MyJurnal DOI: 10.5704/MOJ.1111.001

Epidermoid cyst is a common benign cutaneous swelling frequently encountered in surgical practice. It usually presents as a painless lump frequently occurring in hairbearing areas of the body particularly the scalp, scrotum, neck, shoulder and back. Giant epidermoid cysts commonly occur in hairy areas such as the scalp. We present here the case of a rare occurrence of a giant epidermoid cyst in the less hairy area of the right upper thigh mimicking a soft tissue sarcoma. Steps are highlighted for the management of this unusual cyst.

Matched MeSH terms: Epidermal Cyst

Fulltext Parotid lymphoepithelial cyst: a case report

Rahman, S., Shaari, R., Hassan, R.

Archives of Orofacial Sciences, 2006;1(1):71-75.

MyJurnal

A 48 years old Malay lady with a case of painless soft fluctuant swelling of left parotid gland is reported. The lesion was found to be a cystic lesion through the pre operative examinations and investigations. The cyst was completely excised, taking care not to injure the lower division of the facial nerve. Post recovery was uneventful with no defect of the facial nerve functions. The histologic picture confirmed that the cyst was lymphoepithelial cyst which is so called “branchial cyst”. Through the literature reviews of parotid lymphoepitelial cyst the discussions on prevalence, origin, diagnosis, histological finding, investigation and the modes of treatment are made. The ultra sound was found to be valuable in the pre operative evaluation of the parotid swelling furthermore it is non-invasive, harmless, painless and relatively quick.

Matched MeSH terms: Epidermal Cyst

Fulltext Plunging epidermoid cyst of the floor of the mouth mimicking a ranula

Anusha Balasubramanian, Irfan Mohamad, Purushotman Ramasamy, Avatar Singh Mohan Singh, Lina Ling Chooi, Ferdinand Jesudian Kovilpillai

Malaysian Journal of Medicine and Health Sciences, 2016;12(1):67-69.

MyJurnal

Plunging epidermoid cyst of the floor of mouth is indeed an uncommon entity. A 34-year old Malay
gentleman had presented to our centre with a floor of mouth lesion that extended into the submental
region. Clinical findings and imaging studies pointed towards the impression of a plunging ranula.
Histopathological examination of a completely excised mass via intraoral approach, confirmed the
diagnosis of an epidermoid cyst. He was well on follow up with no subsequent recurrence. We discuss
the nature of epidermoid cyst and its surgical management.

Matched MeSH terms: Epidermal Cyst

Fulltext Sublingual epidermoid cyst resembling sublingual ranula: a case report

Nee, Tan Shi, Roszalina Ramli, Athar, Primuharsa Putra Sabir Husin

Archives of Orofacial Sciences, 2015;10(1):46-51.

MyJurnal

Dermoid cysts are anatomic embryonic abnormalities that are rarely seen in the oral cavity. Histologically, they are further classified as epidermoid, dermoid or teratoid. We report a case in which an 18- year-old girl who developed an epidermoid cyst presenting as a large sublingual swelling occupying the entire floor of the mouth causing snoring and speech difficulty. We emphasized on the clinical steps in achieving an accurate diagnosis, possible differential diagnosis, necessary imaging techniques and management of epidermoid cyst.

Matched MeSH terms: Epidermal Cyst

Fulltext Posterior Fossa Intradiploic Epidermoid Cyst: A case report

Ng, Wei Ping, Liew, BS, Gee, TS, Azmin KR

International Medical Journal Malaysia, 2015;14(2):67-70.

MyJurnal

Epidermoid cysts are rare, benign congenital tumours of ectodermal origin which typically present between
the third to fifth decade. These tumours comprise approximately 0.2-1.8% of all intracranial tumours. Though
these pearly tumours are potentially curable, subtotal resection may lead to catastrophic complications such as
recurrence, granulomatous meningitis and carcinomatous degeneration of cyst wall. We herein report the case
of a 36-year-old man who presented with an unusual mixed density posterior fossa epidermoid cyst on imaging
studies. Total removal not only cures both tumour and seizure attack in this case but also preserves patient’s
neurological function.

Matched MeSH terms: Epidermal Cyst

Fulltext Neurothekeoma palpebrae in association with multiple superficial angiomyxomas: Tegumental Angiomyxoma-Neurothekeoma syndrome (TAN syndrome)

Kah TA, Yong KC, Annuar FH

Clin Pract, 2011 Jul 01;1(3):e67.

PMID: 24765328 DOI: 10.4081/cp.2011.e67

We report a case of 10-year-old Indian girl with history of multiple superficial angiomyxoma, presented with three months history of painless right upper lid swelling. There were no visual dysfunctions. Previously, the patient had multiple superficial angiomyxoma (left pinna, left upper cheek, left upper limb, chest, right axilla, hard palate) and epidermal cyst (chin). The histopathological specimens were negative to S-100 protein antibody. Systemic review and family history was unremarkable. Excision biopsy and upper lid reconstruction were performed. Intraoperatively the tumor was multilobulated, firm, well encapsulated and did not invade the underlying tarsal plate. Histopathological features of the upperlid tumor were consistent with nerves sheath myxoma (neurothekeoma). To the best of the authors' knowledge, this is the first reported case of neurothekeoma in association with multiple superficial angiomyxoma.

Matched MeSH terms: Epidermal Cyst

Fulltext Atypical Clival Chordoma in an Adolescent without Imaging Evidence of Bone Involvement

Hashim H, Rosman AK, Abdul Aziz A, Roqiah AK, Bakar NS

Malays J Med Sci, 2014 Sep-Oct;21(5):78-82.

PMID: 25977639

Clival chordoma is a rare primary bone tumour that arises from the remnant of the notochord and typically occurs in older adults. Upon imaging, the tumour can be seen arising from the clivus and causes clival destruction. This usually provides insight for a diagnosis. Here we present a case of a non-enhancing, pre-pontine mass that was hypointense on T1W and hyperintense on T2W in an adolescent. No clival bone erosion was observed. Based on the age group, imaging findings, and lack of clival erosion, a provisional diagnosis of epidermoid cyst was made and the tumour was resected. This patient was eventually diagnosed with a clival chordoma based on histopathological examination.

Matched MeSH terms: Epidermal Cyst

Fulltext Pre-auricular sinus: an uncommon presentation

Ng JWS, Chew YK, Tan KL, Chong AW

Malays Fam Physician, 2011;6(1):32-33.

PMID: 25606218 MyJurnal

An infected pre-auricular sinus presenting as a post-auricular swelling is commonly misdiagnosed as an infected dermoid or sebaceous cyst. It may even mimic a mastoid abscess leading to further unwarranted investigations and interventions. We present a case of a 25-year-old Malay man who was initially diagnosed with recurrent infected dermoid cyst. At presentation, a right post-auricular inflamed swelling was noted with an overlying old incision and drainage scar. An auricular pit was found at the crus of helix. Using a blunt probe inserted along the sinus tract pus was drained without the need for further surgical incision. Six weeks after the acute episode, patient underwent excision of the pre-auricular sinus with no evidence of recurrence at three months follow up. Awareness by the attending physician of this ‘variant type’ of pre-auricular sinus at patient’s first presentation may negate the need for unnecessary incision and drainage which may subsequently impact the outcome of surgical excision and reduce the risk of recurrence.

Matched MeSH terms: Epidermal Cyst

Fulltext A rare case of a subcutaneous phaeomycotic cyst with a brief review of literature

Manoharan M, Shanmugam N, Veeriyan S

Malays J Med Sci, 2011 Apr;18(2):78-81.

PMID: 22135592

Phaeohyphomycosis consists of a heterogeneous group of fungal infections caused by more than 80 genera and species. Subcutaneous infection usually follows traumatic implantation of a fungus by a wooden splinter that the fungus inh abits as a saprophyte. The growth of the fungus forms verrucous plaques or a painless subcutaneous abscess. We report a subcutaneous cyst (phaeomycotic cyst) in the leg of a 60-year-old woman that developed after a thorn prick at that site. With the provisional diagnosis of an epidermoid cyst, she was treated with a simple excision of the cyst. However, histopathological examination of the cyst revealed the typical features of fungus, and a definitive diagnosis of a phaeomycotic cyst was made. As the infective aetiology was not considered clinically, the specimen was not sent for microbiological culture, and hence the exact species was not identified. As the lesion was localised, simple excision was sufficient treatment, and no recurrence was observed during 12 months of follow-up.

Matched MeSH terms: Epidermal Cyst

Metastatic mucinous carcinoma of the eyelid

Kaur G, Ismail R, Harun H

Malays J Pathol, 2005 Dec;27(2):117-8.

PMID: 17191395

Metastatic eyelid tumours are rare and account for less than 2% of all eyelid neoplasms. We report a case of metastatic breast carcinoma to the eyelid in a 60-year-old Chinese lady presenting with a 2-year history of enlarging, painless nodular lower eyelid swelling. The 1 cm diameter lesion was provisionally diagnosed as a sebaceous cyst. However the excision biopsy revealed a mucinous carcinoma expressing oestrogen receptor protein. She had a past history of mastectomy one year previously and histology showed an infiltrating ductal carcinoma (oestrogen receptor status negative) without evidence of axillary lymph node metastasis. She had completed adjuvant radio- and chemotherapy. Further treatment of the current lesion involved a wide excision which did not show any residual malignancy. She had no other evidence of metastasis and was treated with letrozol. We highlight this case to create awareness among clinicians and opthalmologists on the possibility of metastatic disease as a cause of eyelid swelling, especially in patients with a history of cancer. It may also be the first sign of metastatic disease of an internal malignancy. A review of the literature is also presented.

Matched MeSH terms: Epidermal Cyst/pathology

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