ABSTRACT: To present an overview of varied clinical presentations, investigations and treatment options for Osteolytic skull lesions.It is a prospective study.We conducted this study from January 2013 to December 2015 in the Department of Neurosurgery, Nil Ratan Sircar Medical College and Hospital, Kolkata. During this period, 14 patients presented with osteolytic skull lesions through the outpatient department. All patients were thoroughly investigated with appropriate hematological and radiological investigations and treated following admission, and surgery was performed in the Neurosurgery Department. All were followed regularly in OPD.Total 14 patients were included in the study. Amongst these 7 were male and 7 female. Age group of patients ranged from 5 to 72 years. Of 14 cases, three cases had dermoid cyst, four cases had metastasis, and one each case had epidermoid cyst, intradiploic meningioma, benign cystic lesion, tuberculosis, histiocytosis X, hemangioma, and osteomyelitis. All underwent diagnostic/therapeutic procedures and referred for Radio or chemotherapy where indicated.All scalp/skull lesions need careful clinical correlation, appropriate radiological investigations to establish diagnosis and subject them to suitable treatment.
Project description:Dermoid cysts are rare in the skull base. There have been 10 reported cases of dermoid cysts in the cavernous sinus, two in the petrous apex, and one in the extradural Meckel cave. This is the first case report of a dermoid cyst in the anterior infratemporal fossa attached to the anterior dura of the foramen ovale. The clinical presentation, radiologic findings, histologic features, tumor origin, and operative technique are described along with a review of the literature.
Project description:Echinococcosis, also called hydatid disease, is a parasitic disease that passes from animals to humans. Literature reports suggest very rare cases of cerebral hydatid cysts. Brain involvement with hydatid disease occurs in 1%-2% of all Echinococcus infections. In this report, we aim to emphasize the presentation of such an isolated primary cerebral hydatid cyst, discuss its radiological features, Emergency department management, inpatient medical management, referral to neurosurgery, consequent operative procedures, postoperative care, and outcome.
Project description:Spontaneous ruptures of dermoid cysts are a rare occurrence due to their thick capsules. This is the first systematic review on spontaneously ruptured dermoid cysts. A comprehensive literature search was performed from PubMed, Google Scholar, and MEDLINE. The cases were analysed for patient demographics, presenting signs and symptoms, imaging modalities used, management methods, and outcomes. The majority of cases report an idiopathic cause with symptoms of abdominal pain, distension, and fever. Computed tomography is the most accurate in detecting ruptured dermoid cysts. We also report a case of a 66-year-old who presented with sudden abdominal pain and a low-grade temperature. Imaging showed a 10?cm well-circumscribed hyperechoic mass consistent with a dermoid cyst with no suggestive signs of rupture. She was planned for a laparoscopic bilateral salpingo-oophorectomy. However, intraoperatively, a ruptured dermoid cyst was found with bowel adhesions and chemical peritonitis as cyst contents covered the entirety of the intra-abdominal cavity. Her operative course was complicated by inadvertent iatrogenic small bowel injury, unsuccessful laparoscopy, needing conversion to laparotomy. Despite their benign nature, complications from ruptured dermoid cysts include peritonitis, bowel obstruction, and abscesses. Surgical management by both laparoscopy and laparotomy is successful, with laparotomies more likely to be performed. Complications have mostly no long-term sequelae.
Project description:Dermoid cysts account for 10-20% of ovarian germ cell tumors. Malignant transformation within ovarian dermoid cyst has been reported in 1-2 per cent of the cases. The treatment remains controversial. In women of childbearing age and in the first stages of the disease unilateral annexectomy without adjuvant therapy is recommended. In menopausal women extensive surgery is sometimes performed, no matter what stage of the disease the person is experiencing. We report the case of a menopausal patient with malignant transformation within ovarian dermoid cyst who underwent surgery. She had a favorable outcome.
Project description:Ovarian dermoid cysts are one of the most common benign neoplasms in women. Rectal fistula formation due to an ovarian dermoid cyst, particularly a benign dermoid cyst, is extremely rare. A 17-year-old girl with symptoms of lower abdominal pain, passage of sebaceous materials in the stool, and hematochezia was found to have an 11-cm dermoid cyst complicated with a rectal fistula formation. Laparoscopic repair of the rectal fistula was performed successfully with bilateral ovarian cystectomies. This case presents the rare formation of a fistula between a benign dermoid cyst and the rectum and its treatment using laparoscopic repair without laparotomy.
Project description:Dermoid cysts are benign and congenital ectodermal inclusions. Their occurrence in an intracranial location is quite rare. They constitute 0.1 to 0.7% of all intracranial tumors. Their occurrence in the fourth ventricle and their multicentric feature are extraordinary. A 12-year-old boy was admitted to our clinic with a dermoid cyst with sixth cranial nerve involvement. He had symptoms of increased intracranial pressure. This case is the first dermoid cyst in the literature at this unusual location; a mature tooth structure was found within the cyst, which extended over the cervical subsegments. There was a second dermoid cyst in the thoracic spine (multicentric). Our aim is to present an atypical dermoid cyst along with radiodiagnostic characteristics and macroscopic findings.
Project description:We report the case of a 39-year-old woman who presented in an acute setting with pelvic pain, an adnexal mass on imaging and a high CA19-9 level. She was taken for surgery, where a large dermoid cyst was found at the fimbrial end of a fallopian tube at the time of laparoscopy, with no apparent connection to either ovary and absence of ovarian necrosis. This was corroborated on final histology. Dermoid cysts in aberrant locations are usually reported at Caesarean section or during laparoscopic sterilisation and thus, understandably, a pre-operative CA19-9 level is rarely available. That and the rarity of these 'ectopic dermoids' make it hard to give further support for a causative association with the high tumour marker levels. Some authors suggest that auto-amputation of a dermoid cyst or part thereof and subsequent reimplantation may give rise to this phenomenon, and thus the term 'wandering dermoid' has been applied to similar situations. This is what we postulated as the cause in our case. It is likely that a full understanding of the aetiology of wandering dermoid cysts will remain elusive, given the paucity of cases.
Project description:<h4>Background</h4>Dermoid cysts are well-known lesions that manifest as subcutaneous tumors around the lateral sides of the eyebrows in young patients. Computed tomography or magnetic resonance imaging (MRI) is often performed to confirm the diagnosis. On the other hand, a lipoma is usually a circular lesion, which is sometimes observed in the upper part of the face. The signals of both T1-weighted and T2-weighted images of MRI of a lipoma are, in general, relatively highly homogenous, and the signals decrease in fat-suppressed images. Therefore, differential diagnosis between a dermoid cyst and a lipoma is usually made with MRI, especially based on fat-suppressed images. Here, we present a case of misdiagnosis of a dermoid cyst as a lipoma because of atypical magnetic resonance images.<h4>Case presentation</h4>We report a case of a 24-year-old Japanese woman with a dermoid cyst around the lateral edge of the eyebrow. The cyst had been gradually increasing in size for the past 2 years. On MRI, it showed high internal signals on T1- and T2-weighted images. However, the signal intensity decreased homogeneously in the fat-suppressed T2-weighted images. The observed tumor had a yellowish appearance under the endoscope. On the basis of these findings, the lesion was considered a lipoma until it ruptured intraoperatively. The pathological diagnosis confirmed it to be a dermoid cyst.<h4>Conclusion</h4>Some dermoid cysts contain lipid-rich liquid, and these may be misdiagnosed as lipomas by MRI. When a tumor is located at a common site for a dermoid cyst, the MRI images should be validated carefully if it appears like a lipoma, and the differential diagnosis should be considered carefully.
Project description:To report a rescue technique for complete removal of an accidentally ruptured orbital dumbbell deep dermoid cyst.A 33-year-old female presented with left proptosis with retrobulbar discomfort for 3 months. Computed tomography images showed an orbital dumbbell deep dermoid cyst. A lateral orbitotomy was performed under general anesthesia. The cyst was ruptured during osteotomy of the lateral orbital rim. The cyst was opened vertically from the ruptured site using a Stephen's tenotomy scissors to visually confirm the internal wall of the cyst and to keep the epithelial lining intact while separating the external wall of the cyst from the bone. There was a small defect of the epithelial lining at the inferoposterior margin of the cyst. Granulomatous inflammation of the lacrimal gland was found adjacent to the defect site. The cyst was completely removed and the lacrimal inflammation subsided after the operation.Opening of the cyst is a useful technique to remove the entire epithelial lining of an accidentally ruptured dumbbell dermoid cyst.
Project description:<h4>Introduction</h4>The cervical lymphoepithelial or branchial cleft cyst are benign dysembryologic cystic tumors developing in the anterolateral region of the neck. They are relatively uncommon anomalies.The aims of this study are to analyze the anatomoclinical features and to discuss the modalities of care for the management of this disease.<h4>Presentation of case</h4>We report a case of a 70 years-old woman who was admitted to our department with a complaint of painless mass in the right supraclavicular region. Clinical examination and radiological investigations found a mass compatible with cervical cyst. Treatment consisted of the complete resection of the cyst. histopathological examination found a Cervical lymphoepithelial cyst.<h4>Conclusion</h4>The cervical lymphoepithelial can be easily misdiagnosed. It is imperative that clinicians make an accurate diagnosis for appropriate treatment (that is, surgical excision).