Giant Epidermal Inclusion Cyst in the Male Breast: A Case Report

Abstract

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Giant epidermal inclusion cyst of the axilla: a case report with diagnostic ultrasound imaging features

“…Multiple EICs can occur in patients with Gardner syndrome, which is also associated with intestinal polyposis, osteomas, and thyroid nodules [1] , [2] , [3] . Giant EICs, more than 5 cm in diameter, have been described in previous case reports along with clinical and imaging findings [3] , [4] , [5] , [6] , [7] , [8] . However, occurrence of a giant EIC in the axilla, as in the present case, has not been reported in the imaging literature.…”

“…EICs, also known as epidermal cysts, epidermoid cysts, sebaceous cysts, or infundibular cysts, are benign cystic lesions, which are characterized by the proliferation of epithelial cells locally in the dermal or subcutaneous tissue, leading to the formation of a keratin-filled cyst [1 , 2] . They may result from the obstruction of a pilosebaceous follicle, migration of epithelial cells during embryogenesis, or acquired reasons such as trauma or surgery [3] , [4] , [5] . Clinically, they appear as solitary slowly growing lumps with sizes ranging from a few millimeters to a few centimeters, with or without a central characteristic punctum.…”

“…They usually appear as asymptomatic dermal or subdermal lumps, which are less than 4 cm in diameter and grow slowly without medical attention or treatment. However, if an EIC is more than 5 cm in maximal diameter, it is considered a giant epidermal inclusion cyst, which can cause the patient discomfort, and requires surgical excision as it does not regress with medical treatment alone [ 3 , 4] . Preoperative diagnosis is important for deciding or planning further treatment or management, and imaging-guided biopsy may be required for this purpose.…”

“…Preoperative diagnosis is important for deciding or planning further treatment or management, and imaging-guided biopsy may be required for this purpose. However, iatrogenic rupture during biopsy, just like spontaneous rupture, may release non-absorbable keratin materials from the cyst, which can irritate the surrounding tissues and cause secondary foreign body reaction, granulomatous reaction, or abscess formation [4] . Therefore, if the typical imaging findings of EICs could be identified, it may help in making a preoperative imaging diagnosis without performing a biopsy even if the cyst has an unusual size or location, thereby preventing subsequent complications such as rupture and inflammation.…”

Epidermal inclusion cyst of the axilla with calcifications

“…EIC commonly presents as an asymptomatic lesion that is firm, dome-shaped, and slowly enlarging [3] . Although diagnosing EIC is easy when it is small and subcutaneous, mammography and sonography can misinterpret it with other benign or malignant lesions [4] . Herein, we present a case of a 41-year-old patient presenting with an axillary EIC with calcifications on the mammogram.…”