Nasal Dermoid Cyst with Sinus Tract Intranasal Bone: A Case Report

Dermoid cysts are benign tumors originating from germ cells, which can form in various locations, including the nasal area in rare cases. They are of unknown exact etiology, but it is suggested that it is due to abnormal tissue migration during early embryonic development. Nasal dermoid cysts albeit rare, can present in various forms such as sinuses, fistulas, or intracranially extending tracts. They can be asymptomatic and incidentally discovered or present with a visible external mass or sinus that is either painful, infected or cosmetically concerning. If nasal dermoid cysts with an intra-nasal bone sinus tract are left untreated, they can lead to life-threatening complications. This report describes the case of a 6-year-old girl with a nasal dermoid cyst connected to a superficial punctum by an intra-nasal tract. She had undergone surgical excision of a nasal swelling previously diagnosed as a dermoid cyst. One year later, she returned to our clinic with a recurrence of the nasal swelling. Imaging tests revealed a nasal dermoid cyst with a tract extending to the nasal tip, without intracranial expansion. The cyst, along with the entire tract, was successfully removed surgically, and the postoperative follow-up indicated no complications. Histopathology confirmed the diagnosis of a dermoid cyst. This case underscores the significance of considering the dermoid tract in nasal cyst cases and the necessity of its complete removal to prevent recurrence.

Nasal Dermoid Cyst: A Case Report

Nasal dermoid sinus cysts (NDSCs) are rare neoplasms in the median line of the nasofrontal area. Unlike other dermoid cysts, a NDSC can manifest as a cyst, sinus, or fistula, and may extend intracranially. Nasal dermoid cysts usually present at birth and are commonly diagnosed by 3 years of age. An incidentally detected nasal dermoid cyst in an adult patient is extremely rare. In this case, a 23-year-old female with a history of intermittent serous thick discharge from a pit in the nasal columella since early childhood. Examination of the nasal cavity showed mild septal deviation to the left side, dorsal hump, wide nasal bone, a small pit-sinus at the columella, over projected nose, and wide bulbous down rotated nasal tip. The findings were suggesting nasal dermoid cyst, so a magnetic resonance imaging (MRI) was done for the patient to confirm the diagnosis. The MRI findings showed that there are 3 small cysts at the nasal septum anteriorly with a small fistula connecting the anterior inferior 2 cysts with no involvement to the intracranial cerebrospinal fluid (CSF) space. During the surgery, an open rhinoplasty approach was used. The trans-columellar incision was made around the fistula, and the tract was identified using a lacrimal probe and methylene blue. The dissection around the tract was continued until the sac was identified in the area of the membranous septum, and it was removed and sent for histopathology. The surgery then continued in a regular full rhinoplasty fashion. In conclusion, dermoid cyst of the nasal septum is a rare congenital lesion, especially in adults. After a thorough history taking and physical examination, a preoperative high-resolution axial and coronal CT and/or MRI is essential for diagnostic and operative planning. The treatment of choice for nasal dermoid cysts is complete surgical excision with clear margins. Surgical strategies usually depend on the location and extent of the lesion. Recurrence is uncommon and often easily managed.

Treatment of corneal dermoid with lenticules from small incision lenticule extraction surgery:a surgery assisted by fibrin glue

AIM:To observe the clinical efficacy of the combined use of small incision lenticule extraction(SMILE)-derived lenticule patches in corneal dermoid excision,with fixation of the lenticule patches assisted by fibrin glue.METHODS:Seventeen eyes of 17 patients with corneal dermoid were treated with dermoid removal combined with SMILE-derived lenticule transplantation.All lenticule patches were fixed by fibrin glue.Ocular changes were assessed using slit lamp microscopy and anterior-segmental optical coherence tomography.The best-corrected visual acuity(BCVA)and ocular dioptric variations were examined preoperatively and postoperatively.Intraocular pressure(IOP)was also monitored in all visited time.RESULTS:Totally,18 lenticule patches were used on 17 eyes of 17 cornea dermoid patients.The mean follow-up time was 11.47±5.28mo.All lenticule patches we resuccessfullyg lued,kept on its location and maintained transparent during the follow-up time,with a consecutive epithelial cover for 1wk.Nine of the patients could coordinate visual and optometry exam well.Their preoperative BCVA is 0.60±0.35 in decimal,significantly improved to 0.80±0.26 in decimal at 6mo postoperatively(Z=-2.392,P=0.017),but the changes of their corneal astigmatism diopters showed no significance,with 2.22±1.91 D preoperatively,and 2.28±1.31 D at 6mo postoperatively(Z=-0.135,P=0.893).Limbal pannus formation occurred in 4(23.52%)cases and decreased with the application of tacrolimus eyedrops.IOP increased in 2(11.76%)cases,but well decreased by timolol maleate eyedrops.All the adult patients or guardians of minor patients were satisfied with the cosmetic improvement.CONCLUSION:Dermoid excision combined with transplantation of SMILE-derived lenticule patches using fibrin glue is a safe and effective novel tectonic keratoplasty procedure for corneal dermoid.

Intra osseous dermoid cyst of mandible—A rare case report

The present article report a rare case of intraosseous dermoid cyst in mandible which clinically and radio-graphicaly presented as mandibular cyst. The diagnosis of dermoid cyst was confirmed histologically. A 20 year old patient was admitted to our Department with the complaint of swelling in left lower jaw with occasional pain. Radiographic examination revealed a radiolucent lesion extending from left 2nd molar to right premolar region. On surgical exploration the lesion was cystic in nature full of hair and keratinized tissues. The tissue was sent for the histopathological examination and macroscopic feature reveal numerous bits of soft tissue. The tissues were creamish brown in color, firm in consistency, with largest tissue measuring 2.5 × 1.5 × 0.5 cm in dimension. Few hair follicles were also evident within it. The histopathology reveal cyst lined by stratified squamous hyperor- thokeratinized epithelium supported by a fibrous connective tissue wall. The cystic epithelium is showing melanin pigmentation in the basal cell layer. Ab-undant onion skin keratin is seen within the cyst lumen. The epithelial lining as well as cyst wall shows numerous skin appendages such as lobules of seba-ceous glands. The underlying connective tissue shows mild chronic inflammatory infiltrate mainly composed of lymphocytes.

Simple keratectomy and corneal tattooing for limbal dermoids:results of a 3-year study

AIM:To evaluate and report the efficacy of combined surgical excision and corneal tattooing in patients with limbal dermoids.·METHODS:In a retrospective interventional case series,9 eyes of 8 patients were treated with combined surgery of simple keratectomy and corneal tattooing for limbal dermoids.Medical records,including best-corrected visual acuity,anterior segment photography,demographic,clinical data,and follow-up information were reviewed.·RESULTS:The mean follow up period in this study was 50±15(range 36-77) months.There was no evidence of infection or recurrent limbal dermoids in any of the eyes during the follow-up period.All patients achieved good cosmetic outcomes with no complications.·CONCLUSION:Simple keratectomy and corneal tattooing of limbal dermoids could be an alternative option for surgery,especially when a donor cornea is not available.

Studies of a pedigree with limbal dermoid cyst

AIM: To study clinical features and gene mutations within the paired-like homeodomain transcription factor 2 (PITX2) gene in a pedigree of bilateral limbal dermoids. METHODS: Complete eye examinations have been performed on each individual of the family. Exons of paired-like homeodomain transcription factor 2 ( PITX2)were amplified by polymerase chain reaction, sequenced, and compared with a reference database. RESULTS: We described the phenotype, clinic findings in a family with two affected members. The masses of the proband's eyes were excised surgically demonstrating a dermoid cyst by histopathological examination. No mutation was detected in the gene PITX2 in this pedigree. CONCLUSION: A family of limbal dermoid cyst was reported. In addition, no pathogenic sequence variations were found in PITX2, indicating that this phenotype in this family is a distinctive entity.

Preoperative evaluation and outcome of corneal transplantation for limbal dermoids：aten-yearfollow-up study

AIM： To summarize preoperative evaluation and outcome of corneal transplantation for limbal dermoids for ten years.METHODS： Eighty-five patients diagnosed with limbal dermoids and treated with corneal transplantation were analyzed retrospectively. All patients were further divided into two groups according to absence or presence of neovascularization surrounding the dermoids in the corneal stroma. Eighty-two eyes were treated with tumor excision combined with partial lamellar sclerokeratoplasty, and the other three eyes were performed by penetrating keratoplasty. The size and location of the tumor, the associated ocular and systemic anomalies, the depth of the corneal penetration of tumor tissues, the preoperative and postoperative best-corrected visual acuity （BCVA）, graft survival and cosmetic outcome, and surgical complications were recorded respectively.RESULTS： The average age at surgery was 5.3y （range, 3mo-36y）. The mean size of dermoids was 6.1±1.6 mm. The 43.5% of eyes （37/85） were present with hair at the surface of the dermoid and 72.9% of dermoids were located inferotemporal of the eye. Amplyopia was present in 34.1% of patients （29/85） and 9.4% of patients （8/85） had lipodermoids. Eighteen patients suffered from Goldenhar’s syndrome with an accessory ear. The 75% of patients in group 1 had involvement of the corneal deep stroma down to Descemet’s membrane without involving it, but 71.4% of patients had Descemet’s membrane involvement in group 2. Preoperative BCVA ranged from counting fingers to 20/20. Postoperatively 81.1% had a BCVA of 20/800 or better. There was no significant difference between the post-surgical BCVA of the two groups （t=1.584, P〉0.05）. The grafts of 70.5% patients were present as 1＋ opacity, 21.1% as 2＋ opacity, 8.2% as 3＋ opacity and none as 4＋ opacity. Surgical complications included graft rejection, microperforation, prolonged reepithelialization, steroid glaucoma, interface neovascularization, and interface hemorrhage.CONCLUSION： The dermoids with neovascularization surrounding them in the corneal stroma invaded deeper tissues in the cornea than those with no neovascularization surrounding them in the corneal stroma. Therefore, surgeons should take care to avoid corneal perforation during the corneal transplantation operation. The majority of patients markedly improved their cosmetic appearance after surgery.

Dermoid Ovarian Cyst Complicated with Torsion in a Girl of 11 Years Old at the Teaching Hospital Sanou Souro of Bobo-Dioulasso (Burkina Faso): About an Observation and Review of the Literature

The dermoid ovarian is an organic mild tumor. It can be revealed by an adnexal torsion which constitutes a gynecological emergency that can bring into play in a short term after the functional prognosis. We are reporting an observed case in an 11-year-old teenager who is in times peri-pubertal. The patient was presenting a painful abdomino-pelvic syndrome and a pelvic mass at the physical examination. The ultrasound was showing a right cyst mass with a right moderated hydronephrosis. A right adnexectomy was realized. The histological test after excision of the adnexal was showing a mature cystic teratoma of the right ovary with a congestive and edematous tubal fragment.

Dermoid cyst in a domestic shorthair cat

A S-year-old neutered male domestic shorthair cat was presented for examination of a subcutaneous mass in his tail.The mass was firm,non-painful,oval,and approximately 2.5×3.5 cm. Surgical exploration revealed a well-circumscribed,encapsulated mass.The mass was removed and sectioned for histopathological examination.In gross section,it was filled with numerous dark hairs.Histologically the mass was consisted of haired skin with dermal cystic structures lined by stratified squamous epithelium.The cyst lumen contained squamous debris and filled with keratinous material.Numerous hair shafts were extended from the wall of the cyst.The sebaceous and apocrine gland adnexal structures were also observed which confirmed the diagnosis of dermoid cyst.No tumor recurrence was observed after surgery in fallowing checkups.Cutaneous or subcutaneous cysts of all types are considered rare in cats and to our knowledge this is the third reported case of cutaneous dermoid cyst of cats in veterinary literature which is different from the other cases because it occurred in dorsal midline in tail area whereas other's occurred in flank area.

Lamellar keratoplasty with corneoscleral graft for limbal dermoids

To assess the postoperative outcomes of limbal dermoid excision with corneoscleral graft transplantation. The charts of 8 consecutive patients （mean age： 13.0y） who had undergone limbal dermoid excision with lamellar corneosclerai graft transplantation by a single surgeon were retrospectively reviewed. Mean dermoid size was 7.75 mm （6.0-12.0 mm）. Mean visual acuities （in IogMAR units） before and after surgery were 1.8 and 1.7, respectively （P=0.29）. Spherical equivalents were 1.3 diopter （D） before surgery and 0.7 D after surgery （P=0.40）. The mean astigmatism measurements before and after surgery were 2.4 D and 1.5 D, respectively （P=0.17）. Vector analysis revealed a mild change in astigmatism with a mean ＂d＂ of 3,2 （0,56-6.89）, No intra- or post-operative complications occurred. Lamellar keratoplasty for limbal dermoids is safe and offers good cosmesis and tectonic stability. A significant decrease in the amount of astigmatism is not expected following surgery.

Two sequential surgeries in infant with multiple floor of the mouth dermoid cysts: A case report

BACKGROUND Multiple intraoral dermoid cysts of large magnitude generally appear in the second or third decade of life.They are rare in infants and are usually solitary.In this case,a large mass was identified in utero during prenatal exams.CASE SUMMARY We introduce a rare case on multiple dermoid cysts in the floor of the mouth of an infant who underwent two surgeries for this.Preoperative magnetic resonance imaging confirmed a large well-circumscribed cystic lesion that originated at the former midline region in the floor of the mouth in which a suspicious lesion of minute size was likely compressed by the bulkier mass and overlooked.Therefore,the infant underwent two surgeries by an intraoral approach within 9 mo.At 5 mo after the second operation,a routine follow-up ultrasound showed evidence of an additional cyst.No further surgery was planned because the tumor had no immediate effect.CONCLUSION This report demonstrates the importance of carefully analyzing preoperative imaging to avoid multiple operations for a seemingly isolated oral cyst.

Asymptomatic traumatic rupture of an intracranial dermoid cyst:A case report

BACKGROUND Previous studies reported that most of the intracranial dermoid cyst ruptures were spontaneous,and only a few were traumatic,with asymptomatic much rarer than the symptomatic ruptures.Hence,how to deal with the asymptomatic traumatic rupture of intracranial dermoid cyst remains a challenge in the clinic.CASE SUMMARY A 59-year-old man was accidentally diagnosed with intracranial dermoid cyst through a cranial computed tomography(CT)scan due to a car accident.A mixed-density lesion with fat and a calcified margin was observed in the midline of the posterior fossa,accompanied with lipid droplet drifts in brain sulci,fissures,cisterns,and ventricles.After 1 wk of conservative observation,no change was observed on the updated cranial CT scan.After 2 wk of conservative observation,magnetic resonance imaging examination confirmed that the lesion was a traumatic rupture of a posterior fossa dermoid cyst with lipid droplet drifts.As the patient exhibited no adverse symptoms throughout the 2 wk,a 6-mo follow-up visit was arranged for him instead of aggressive treatment.Nonetheless,the patient did not show any abnormal neurological symptoms in the 6 mo of follow-up visits.CONCLUSION Asymptomatic traumatic rupture of intracranial dermoid cyst could be just followed or treated conservatively rather than treated aggressively.

Challanging Management of a Giant Sublingual Dermoid Cyst Rapidly Enlarged Throughout Pregnancy and Influence of Hormonal Factors

The authors present a case with a sublingual giant dermoid cyst, rapidly enlarged during pregnancy, which showed itself with deglutition and mild respiratory problems. Dermoid cysts (DCs) are benign lesions arising from entrapment of epithelial rests during embryogenesis. They are most frequently located in the ovaries and testes. Up to 6.9% are found in the head and neck and 1.6% within the oral cavity, representing less than 0.01% of all oral cavity cysts. They usually present early in life as asymptomatic masses with slow and progressive growth. However, they may reach a large size with a potential impact on deglutition, speech, and respiration. It is suggested that the rapid growth of DCs during pregnancy is associated with the increase of plasma levels of estrogens and progesterone. In order to eliminate respiratory and deglutition issues, it was decided to perform the surgical excision after a cesarean delivery at 29th week.

Rupture of a Posterior Fossa Dermoid Cyst Overlying the Torcular with Extracranial Extension: Technical Note

Intracranial dermoid cysts are congenital benign neoplasms mostly diagnosed in the pediatric?hood and usually involve the midline structures. They count approximately less than 1% of all intracranial neoplasms and are believed to arise from ectopic cell rests incorporated in the closing neural tube. These dermoid cysts, especially those involving the posterior fossa and overlying the torcular, are uncommon. We report perhaps the first case of this entity in a third-year-old boy and discuss the physiopathogenesis, the imaging features and the best technical note to manage this cyst in this location.

An Intragaleal Frontal Dermoid Cyst: A Location Never Reported

All dermoid cysts arising at the cranial vault had been reported as being located subgaleally, i.e. under the galea aponeurotica or epicranium. We are presenting a case that we believe to be the first case of an intragaleal dermoid cyst ever reported. An eighteen years old girl presented at our consultation for a midline frontal swelling evolving since 2 years. Neurological examination was normal. The Computed Tomography (CT) scan showed a round shaped heterogeneous mass at the vertex with no intracranial extension. The lesion was excised surgically. It appeared to be located intragaleally (within the epicranium) and composed of hairs and liquefied fat evocative of a dermoid cyst. The diagnosis of dermoid cyst was confirmed on histology. Postoperative outcome was excellent and the patient is symptom-free 16 months after surgery.

A Girl with Life Threatening Meningitis Caused by an Infected Dermoid Cyst Derived from an Occult Dermal Sinus

Congenital dermal sinuses are a rare entity of spinal dysraphism. Most patients have cutaneous markers of their presence, including nevus or port wine stains, dimple, hypertrichosis and subcutaneous lipoma. Inclusion tumors, such as dermoid tumor, are associated to dermal sinus tract;they are congenital, benign and slow-growing lesions of midline. Their clinical relevance is due to the possibility of causing infection, spinal abscess, signs of corde or nerve root compression. Spinal Magnetic Resonance Imaging (MRI) is the diagnostic tool of choice. We present the case of a child with atypical meningitis, resistant to large spectrum antibiotic therapy, caused by an infected dermoid cyst, undiagnosed in the first months of life despite repeated MRI.

Congenital Frontal Mature Dermoid Cyst: A Case Report

Dermoid cysts are uncommon congenital or acquired developmental cystic malformations that were usually seen in the midline of frontal region and the anterior fontanel. Congenital forms develop from the remnants of the epithelium or ectodermal membranous bone growth line. We report here a case of a congenital frontal dermoid cyst that should be considered in the differential diagnosis of lipoma and neurofibroma. Dermoid cysts should be considered in the differential diagnosis of all nodular cyst-like lesions in the head and neck region. Early recognition and accurate diagnosis by means of Computerized Tomography scan or Magnetic Resonance Imaging facilitate successful treatment.

An Extremely Rare Case Report of Foramen Magnum Dermoid Cyst Presenting as an Acute Progressive Neurologic Deficit

Intracranial dermoid cysts are nonneoplastic lesions that present a rare clinical entity. They account for 0.04% to 0.6% of all intracranial tumors. Such cystic lesions usually contain different ectodermal derivatives including hairs, sebaceous glands, apocrine gland and teeth. Dermoid cysts of foramen magnum occur very rarely, with few cases reported in the literature. Computed tomography (CT) and magnetic resonance imaging (MRI) are two main diagnostic tools. Here in this paper, we described a case of intracranial (foramen magnum) dermoid cyst presented with neurologic deficits that completely removed surgically.

Management of Recurrent Nasal Dermoid in an Adolescent with Nasal Pyramid Deformity

Nasal dermoids are congenital midline masses accounting for 1% - 3% of all dermoids. The majority of lesions are superficial with no deep extension;a variable reported percentage might end blindly within the deeper midline structures of the nose or extend intracranially. Sequelae of infection can result in osteomyelitis, meningitis or cerebral abscess. These complications may result from inadequate surgical excision. We report a case of recurrent nasal dermoid that had associated nasal pyramid deformity.

Amniotic Membrane Grafts in Pediatric Corneal Limbal Dermoids with Conjunctival Eyelashes: A Case Presentation

Purpose: To report a case of a pediatric corneal limbal dermoid with eyelashes and to describe post-operative changes after excision with reconstruction using amniotic membrane grafting, sutures and fibrinogen-thrombin glue. Case Report: One pediatric patient was identified with a grade II infratemporal corneal-limbal dermoid with conjunctival eyelashes. The dermoid was surgically excised and the cornea reconstructed with amniotic membrane using sutures and fibrinogen/thrombin glue. Preoperative and postoperative measurement of astigmatism, anisometropia and presence of exposure keratopathy were performed.