Dermoid cyst of the anterior fontanelle in adults: case report

Abstract

-Head and neck dermoid cysts are lesions relatively rare, which usually occur during childhood as solitary lesions. They are often identified and surgically removed at birth, being uncommon in adults. A 23-year-old male presented with a congenital tumor of the anterior fontanelle, which histopathological examination revealed a dermoid cyst. Surgical intervention is the treatment of choice to remove this lesion. The objective of this study is to report the case, once this type of lesion is rare in adults.KEY WORDS: dermoid cyst, epidermoid cyst, anterior fontanelle, adult.Cisto dermóide na fontanela anterior de adulto: relato de caso RESUMO -Cistos dermóides de cabeça e pescoço são relativamente raros e, usualmente, ocorrem na infân-cia como lesões solitárias. Eles são diagnosticados e operados ao nascer, na maioria dos casos; portanto, essa é uma lesão incomum no adulto. Um homem de 23 anos apresentava tumoração congênita na fontanela anterior, cujo exame histopatológico revelou ser cisto dermóide. Foi submetido a tratamento cirúrgico. O objetivo desse estudo é relatar o caso, uma vez tratar-se de condição rara no adulto. PALAVRAS-CHAVE: cisto dermóide, cisto epidermóide, fontanela anterior, adulto.Head and neck dermoid cysts are relatively rare, and usually occur during childhood as solitary lesions 1 . The cysts over the anterior fontanelle represent about 0.1% of all skull tumors and they are identified and surgically removed at an early age. Therefore, this pathology is rarely observed in adulthood. In order to correctly identify these lesions, diagnostic imaging such as simple X-rays and computer tomography (CT) scan are necessary, besides physical evaluation 2 .We report a case of dermoid cyst over the anterior fontanelle in an adult patient. CASEA 23-year-old man seeked medical help at the Neurology department of Instituto Doutor Jose Frota hospital with a mass over the anterior fontanelle, diagnosed as congenital, which increased in size over the years since the birth (Fig 1). The patient did not show neurological symptoms. The CT scan of the skull demonstrated extracranial lesion with cystical appearance, without intracranial communication (Fig 2). During the excision of the lesion, it was observed a cyst containing a viscous, odorless, and greencolored liquid, with hair (Fig 3). The bacterioscopy of this liquid was negative. The cyst was removed together with its walls, the excess of scalp was ressected, and the skull was properly covered with the patient's skin maintaining the natural hair line. A skull depression underneath the lesion could be observed. A drain with continuous suction was positioned and removed after two days containing a serum-bloody secretion. The histopathological exam of the lesion revealed dermoid cyst. There were no surgical intercurrencies, and the patient recovered without complaints and very satisfacted with the functional and aesthetical results. DISCUSSIONAdeloye and Odeku 3 were the first authors to publish a complete description of the dermoid cyst. The congenit...

Dermoid Cysts of the Anterior Fontanel in Adults

“…Surgical excision was curative. deCastro and others [4] also presented a 23 year old man with a scalp swelling at the region of the anterior fontanelle without any neurological issues. CT scan did not show any intracranial extension.…”

Bregmatic dermoid cyst in a patent anterior fontanelle

“…[1,2] BDC is rarely reported in the adult patient. [1,3,4] This is the first report of an Indian adult patient presenting with a BDC. Associated scalloping of the outer table of the calvarium has been reported, [3] but never a patent anterior fontanelle (AF).…”

“…[1] A 20-year old male presented with history of a scalp swelling Bregmatic dermoid cyst in a patent anterior fontanelle BDC is a benign inclusion cyst, arising from dermal elements during ectodermal folding of the neural tube at the end of the 1 st month of embryogenesis. [4] BDC is described predominantly in children. [1] Only six adult patients in five reports are noted [4] [ Table 1].…”

“…[4] BDC is described predominantly in children. [1] Only six adult patients in five reports are noted [4] [ Table 1]. This is the first report of BDC in an adult from the Indian subcontinent.…”

Scalloping characteristics in anterior fontanelle dermoid cyst

“…[12] A 3-month-old male infant presented with a gradually increasing swelling located in the midline over the vertex of the head since birth. There were no other associated abnormalities and the child had normal growth and developmental milestones.…”