Intraosseous epidermoid cyst of the skull: case study and radiological imaging considerations

Twede, James V.; Patterson, P. Daniel; Anderson, Mike

doi:10.5070/d3247040927

Cited by 7 publications

(8 citation statements)

References 18 publications

(23 reference statements)

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“…Concerning features include congenital defects, midline or cranial suture line locations, lesions that feel tethered to the skull, palpable bony "step-offs," the presence of clear fluid that may represent cerebrospinal fluid, or a history of head trauma in that location. 3,4 The original examination findings for this patient are unknown because his cyst had been surgically manipulated preceding our first assessment. At the time of presentation to the authors' clinic, no prominent indications that the cyst traversed the skull were apparent; however, the case was unusual enough to warrant ultrasound imaging before surgery.…”

Section: Discussionmentioning

confidence: 99%

A Hole in the Head: An Intradiploic Epidermoid Cyst With A Calvarial Defect

et al. 2022

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Section: Discussionmentioning

confidence: 99%

A Hole in the Head: An Intradiploic Epidermoid Cyst With A Calvarial Defect

et al. 2022

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“…1 When located on the scalp, they may erode the calvarium, perforate the dura, rupture into the subarachnoid space, or involve the brain parenchyma. 1,4 It is important to discern the extent of involvement within the calvarial bone and dura before surgical excision. Computed tomography (CT) scan and/or MRI are recommended preoperative imaging modalities.…”

Section: Discussionmentioning

confidence: 99%

“…Congenital epidermoid cysts are presumed to result from epidermal remnants of cells being entrapped during weeks 3 to 5 of embryogenesis, which slowly manifests over time into palpable, firm, nontender nodules. 4 Acquired epidermal cysts are often caused by trauma or an iatrogenic cause bringing epidermal tissue structures deeper into the dermis where they will become entrapped. 4 Complete excision is the treatment of choice for epidermal cysts, and during excision, the entire intra-epidermal capsule must be removed to prevent recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…4 Acquired epidermal cysts are often caused by trauma or an iatrogenic cause bringing epidermal tissue structures deeper into the dermis where they will become entrapped. 4 Complete excision is the treatment of choice for epidermal cysts, and during excision, the entire intra-epidermal capsule must be removed to prevent recurrence. The recurrence rates of epidermoid tumors range between 8.3% and 25% and are likely because of residual capsule remaining after resection.…”

Section: Discussionmentioning

confidence: 99%

“…Skin dimpling, contour irregularity, visible threads, and thread extrusion were the most common complications in a retrospective review. 4 We present a patient with PDO threads of the lid-cheek junction (LCJ) that were retained and fully intact 2 years postimplantation.…”

Section: Retained Periorbital Subdermal Polydioxanone Threadsmentioning

confidence: 99%

See 2 more Smart Citations

Epidermoid Cyst With Erosion Into the Calvarial Intradiploic Space

Hornback,

Bax,

Holmes

et al. 2023

Dermatol Surg

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Intraosseous epidermoid cysts of adjacent digits in a dog

Vagias

Cassidy²,

Skelly

et al. 2020

BMC Vet Res

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Background Intraosseous epidermoid cyst (IEC) is a rare, non-neoplastic, pathology in animals and humans that most commonly affects the distal phalanx. In dogs, it is important to differentiate this lesion from malignant digital tumours causing bone lysis. In previous reports, IEC has been described to affect only a single digit at the time of diagnosis which is usually based on histopathology. This is the first case report to describe immunohistochemically confirmed IECs affecting simultaneously multiple digits. Case presentation A 4-and-a-half-year-old female spayed Great Dane was presented with a 2-month history of progressive swelling of the distal phalanx (PIII) of digits IV and V of the right pelvic limb. Eleven weeks prior to presentation, the dog had a low-grade cutaneous mast cell tumour completely excised from the craniolateral base of its left pinna. A history of trauma to 1 of the nails of the same pes 4 years prior to referral was also reported. Examination of the right pelvic limb identified firm non-painful swelling of PIII of digits IV and V, with concurrent deformation of the nails. Radiographs of the right pes obtained by the primary veterinarian identified an expansile lesion of PIII of digits IV and V. Computed tomography identified large expansile lesions of PIII of digits IV and V, with associated cortical thinning and soft tissue swelling. Neoplasia was considered the most likely radiographic diagnosis. Histopathology of Jamshidi bone biopsies was consistent with intraosseous epidermoid cyst, which was confirmed with immunohistochemistry. Amputation of PIII of digits IV and V at the level of mid-PII was performed as definitive treatment. No recurrence of the lesion occurred during the 10-month follow-up period. Conclusions Intraosseous epidermoid cysts should be included in the differential diagnosis for expansile lesions affecting the canine digit. It is important to differentiate them from other digital lesions, with bone involvement, such as malignant digital tumours, which often require more extensive surgery for definitive treatment. The case herein highlights that this lesion can affect simultaneously multiple digits. Definitive diagnosis can be achieved by identification of keratin-producing epithelial cells on histopathology and confirmed by pancytokeratin labelling.

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Intraosseous epidermoid cyst of the skull: case study and radiological imaging considerations

Cited by 7 publications

References 18 publications

A Hole in the Head: An Intradiploic Epidermoid Cyst With A Calvarial Defect

A Hole in the Head: An Intradiploic Epidermoid Cyst With A Calvarial Defect

Epidermoid Cyst With Erosion Into the Calvarial Intradiploic Space

Intraosseous epidermoid cysts of adjacent digits in a dog

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