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Pediatrics in Review Jun 2020Neonates often have congenital lumps or sinuses. It is expected that pediatricians will distinguish those with important physiologic implications from those without.... (Review)
Review
Neonates often have congenital lumps or sinuses. It is expected that pediatricians will distinguish those with important physiologic implications from those without. Accurate understanding of these lesions is important for the practitioner to avoid unnecessary tests and anxiety and to ensure that seemingly benign lesions with important implications are addressed in a timely manner. This review aims to clarify the consequences of some lesions that can easily be misinterpreted, offering guidance in the initial management of patients with congenital lumps or sinuses. We address several lesions that can easily be misconstrued, including wattles, preauricular lesions, sacral sinuses, second branchial cleft anomalies, torticollis, and dermoid cysts.
Topics: Branchial Region; Dermoid Cyst; Humans; Infant, Newborn; Infant, Newborn, Diseases; Sacrum; Skin Abnormalities; Torticollis
PubMed: 32482690
DOI: 10.1542/pir.2018-0256 -
European Journal of Obstetrics,... Aug 2020Dermoid cysts (benign mature cystic teratoma) are a relatively common cause of adnexal torsion. We aimed to identify the clinical and surgical characteristics associated...
OBJECTIVE
Dermoid cysts (benign mature cystic teratoma) are a relatively common cause of adnexal torsion. We aimed to identify the clinical and surgical characteristics associated with adnexal torsion involving dermoid cysts.
STUDY DESIGN
Retrospective review of all cases of ovarian dermoid cysts (as diagnosed by pathology evaluation) operated in our department between 2008-2019. We collected information on demographic characteristics, clinical presentation, and surgical findings and compared those parameters among women with and without adnexal torsion.
RESULTS
The study cohort included 231 patients who were operated for ovarian dermoid cysts. Of these, the surgery was performed urgently for suspected adnexal torsion in 77 (33.3%) cases, while adnexal torsion was surgically diagnosed in 51 (22.1%) cases. Diagnosis of torsion was significantly associated with younger mean age (28.8 ± 14.4 years in torsion cases versus 34.5 ± 14.8 years in non-torsion cases, p = 0.01), but not with the mean cyst diameter (81.9 ± 26.3 mm in the torsion group versus 74.7 ± 35.9 mm in the non-torsion group, p = 0.1). Regarding cyst size, torsion was found in women with cyst diameter ≤ 55 mm (9 cases, 17.7% of torsion cases), 60-90 mm (30 cases, 58.8%), and ≥ 100 mm (12 cases, 23.5%) (p = 0.1 for comparison between all groups and p = 0.05 for comparison between the small diameter group versus the intermediate/large diameter groups). Although abdominal pain was reported in most women with and without torsion, patients with adnexal torsion were significantly more likely to present with nausea and/or vomiting (24 cases [47.1%], versus 14 cases [7.8%], respectively, p < 0.001).
CONCLUSION
Torsion of dermoid cysts is associated with younger age, but not with the mean cyst's diameter. Surgical removal of dermoid cysts should be considered in pre-menarchal girls, adolescents and young women to prevent adnexal torsion.
Topics: Adnexal Diseases; Adolescent; Adult; Dermoid Cyst; Female; Humans; Ovarian Cysts; Ovarian Torsion; Retrospective Studies; Risk Factors; Torsion Abnormality; Young Adult
PubMed: 32473535
DOI: 10.1016/j.ejogrb.2020.05.033 -
The Journal of Craniofacial SurgeryEpidermoid and dermoid cysts (ECs and DCs) are congenital anomalies occurring in areas of embryonic fusion. Their incidence in the head and neck region is low and ranges...
Epidermoid and dermoid cysts (ECs and DCs) are congenital anomalies occurring in areas of embryonic fusion. Their incidence in the head and neck region is low and ranges from 1.6% to 7%. The aim of this study is to report on the clinical characteristics, treatment, and outcome of 22 patients from a single-institution experience. A retrospective analysis of patients treated for ECs and DCs of the head and neck over a 12-year period was performed. The present study included 22 patients (male/female ratio 1:1). The mean age of presentation was 11.68 years. The lesions were distributed in the orbital regions in 7 (31.82%) patients, auricular regions in 6 (27.27%), neck regions in 5 (22.73%), floor of the mouth in 3 (13.64%), and nose in 1 (4.55%). Complete surgical excision was performed as a definitive treatment method in 21 patients (95.45%). The mean size of the excised lesions was 21.36 mm at the widest length (range: 10-70 mm). On the basis of histopathological examinations, 15 (71.43%) lesions were classified as ECs and 6 (28.57%) as DCs. Post-operative complications were noted in 3 (14.29%) patients--2 (9.52%) with recurrences and 1 (4.76%) with hypertrophic scarring. All of these patients were successfully cured after a second surgery. The ECs and DCs of the head and neck present an interesting diagnostic and therapeutic challenge. Successful management depends on a thorough knowledge of their clinical and radiological features.
Topics: Child; Dermoid Cyst; Epidermal Cyst; Female; Head; Head and Neck Neoplasms; Humans; Male; Neoplasm Recurrence, Local; Retrospective Studies
PubMed: 32796308
DOI: 10.1097/SCS.0000000000006834 -
The Journal of Craniofacial SurgeryDermoid cyst is a congenital and benign disease with most occur on the head and neck. It is rarely that occur on the nasal tip and nasal septum at same time and rarely...
Dermoid cyst is a congenital and benign disease with most occur on the head and neck. It is rarely that occur on the nasal tip and nasal septum at same time and rarely repair of using nasal septum mucosa. The authors treated a child with dermoid cyst in the nasal tip and septum. Only the dermoid cyst at the tip of the nose caused the change of appearance. Dermoid cyst of nasal septum did not cause any clinical symptoms. She underwent excision of the dermoid cyst at the tip of the nose and endoscopic surgery for the dermoid cyst in the nasal septum and used the nasal septum mucosa for repair at the same time. After 6 months of recovery, the appearance of the nasal tip recovered well without obvious scar, the nasal septum area recovered well, and the local stoma was unobstructed without recurrence. The authors found that this kind of nasal septal cyst with no clinical symptoms can achieve good therapeutic effect through endoscopic surgery and repair of using nasal septum mucosa, with less damage, rapid recovery, and good prognosis.
Topics: Child; Dermoid Cyst; Endoscopy; Female; Humans; Nasal Septum; Nose Diseases; Nose Neoplasms
PubMed: 34690325
DOI: 10.1097/SCS.0000000000008281 -
Medicine Jun 2023The mature cystic teratoma of the ovary (MCTO), is composed of mature differentiated elements, thus showing highly differentiated tissue and highly morphological... (Review)
Review
RATIONALE
The mature cystic teratoma of the ovary (MCTO), is composed of mature differentiated elements, thus showing highly differentiated tissue and highly morphological heterogeneity. Although gastrointestinal epithelium can be identified in 7% to 13% of cases of MCTO, the occurrence of visible, functional, and fully developed loop tissue is rare in clinical practice.
PATIENT CONCERNS
A 17-year-old female patient presented with persistent abdominal pain.
DIAGNOSIS
The patient was diagnosed with MCTO where a visible, functional intestinal loop was observed during laparoscopic surgery. Microscopy of the intestinal structure indicated a well-organized, intact layer of intestinal wall.
INTERVENTIONS
An emergency single-port laparoscopic excision of the right ovarian cyst and histopathology were performed.
OUTCOMES
After 2 years of follow-up, there were no signs of recurrence in the patient.
LESSONS
The immune signature of CK7-/CK20+ is characteristic of tumors of gastrointestinal origin and can be used to distinguish tumors associated with mature cystic teratoma. Besides, gynecologists should keep an eye on the possibility of malignant transformation malignant transformation of MCTO.
Topics: Female; Humans; Adolescent; Dermoid Cyst; Teratoma; Ovarian Neoplasms
PubMed: 37390246
DOI: 10.1097/MD.0000000000034081 -
Cureus Aug 2021Mature cystic teratoma (MCT) is a common benign ovarian germ cell tumor. It is more predominantly seen in premenopausal women and contains at least two or more...
Mature cystic teratoma (MCT) is a common benign ovarian germ cell tumor. It is more predominantly seen in premenopausal women and contains at least two or more well-differentiated germ cell layers. It is termed a dermoid cyst if the ectodermal tissue is the predominant component. The complications of a dermoid cyst include torsion, malignant degeneration, rupture, and infection. The incidence of a ruptured dermoid cyst is around 1%-2% resulting in chemical aseptic peritonitis from spillage of the cyst contents. Usual clinical presentation is with diffuse abdominal or pelvic pain and abdominal distension. Around 93-96% of dermoid cysts demonstrate fat in the cyst cavity however, minimal or no fat poses diagnostic challenges. In this case, we discuss a rare case of spontaneously ruptured lipid-poor and thyroid tissue-rich left ovarian dermoid presenting with chemical peritonitis. Special magnetic resonance (MR) Imaging sequences such as fat saturation imaging, chemical shift imaging, and gradient-echo imaging assist in detecting scant amounts of fat in the cyst cavity or cyst wall.
PubMed: 34513476
DOI: 10.7759/cureus.16903 -
Cureus Dec 2019The role of preoperative CA 19-9 levels in patients with ovarian mature cystic teratoma (MCT) and the association of elevated levels of the biomarker with patients' and... (Review)
Review
The role of preoperative CA 19-9 levels in patients with ovarian mature cystic teratoma (MCT) and the association of elevated levels of the biomarker with patients' and tumor characteristics were evaluated. Four electronic databases were searched for articles published up to September 2019. Trials that evaluated the significance of elevated CA 19-9 in patients with ovarian MCTs and publications with > 20 patients were considered eligible for inclusion. Seven studies that included 995 patients with an ovarian MCT who were evaluated with elevated (n = 364) or normal (n = 631) CA 19-9 levels were included. Mean tumor size was significantly increased in patients with elevated CA 19-9 levels (p = 0.038). The rate of ovarian torsion was significantly increased in the elevated CA 19-9 group (p = 0.04). The present study highlights the importance of CA 19-9 as a marker in the diagnosis of MCT, and a meta-analysis supports that it could raise a high degree of clinical suspicion of early recognition of torsion and early surgical management due to complications related to increased size. Nonetheless, the diagnostic value of CA 19-9 is still limited and CA 19-9 can still serve only as a supplementary diagnostic tool in patients with MCTs.
PubMed: 31938630
DOI: 10.7759/cureus.6342 -
Ophthalmic Plastic and Reconstructive...Two healthy 12-year-old monozygotic twin sisters presented with strikingly similar, painless orbital masses along their frontozygomatic suture line that had been slowly...
Two healthy 12-year-old monozygotic twin sisters presented with strikingly similar, painless orbital masses along their frontozygomatic suture line that had been slowly enlarging since birth. The masses were clinically consistent with orbital dermoid cysts and the patients underwent excision of their lesions, with the diagnosis confirmed by histological analysis. There are prior case reports of both nasal and ovarian dermoid cysts in twins, however, no prior case of orbital dermoid cysts in twins have been described. These dermoid cysts are generally thought to be a sporadic disorder of embryogenesis, yet the authors' case suggests genetics may play a role in the underlying etiology of dermoid cysts.
Topics: Child; Female; Humans; Dermoid Cyst; Nose; Orbital Neoplasms; Tomography, X-Ray Computed; Twins, Monozygotic
PubMed: 37133396
DOI: 10.1097/IOP.0000000000002401 -
The Journal of Craniofacial Surgery Oct 2020Dermoid cyst is a rare benign tumor and about 7% of occurrences are found in the head and neck region. Its location is almost always in the midline of the body such as...
Dermoid cyst is a rare benign tumor and about 7% of occurrences are found in the head and neck region. Its location is almost always in the midline of the body such as the orbit, oral cavity, and nose, but it is rarer in and around the auricle. The authors present a 31-year-old woman with dermoid cyst in the postauricular area which is a rare site for this lesion. In surgery under local anesthesia, the mass was limited to the subcutaneous area and excised completely. Surgical excision should be considered for cosmetic reasons and the mass should be excised completely to prevent recurrence and infection. Histopathologic confirmation is important and mandatory after excision to confirm the pathologic diagnosis and rule out the possibility of malignancy.
Topics: Adult; Dermoid Cyst; Ear Auricle; Ear Neoplasms; Female; Humans
PubMed: 32487830
DOI: 10.1097/SCS.0000000000006499 -
Frontiers in Oncology 2023Intracranial germ cell tumors (GCTs) are highly heterogeneous and rare, and the recurrence of mature teratomas is uncommon. There is limited data on the systematic...
Intracranial germ cell tumors (GCTs) are highly heterogeneous and rare, and the recurrence of mature teratomas is uncommon. There is limited data on the systematic management of multiple recurrent tumors following total teratoma removal. Herein, we report repeated relapsing GCTs with different histological subtypes and locations after en bloc total resection of a pineal mature teratoma. A 14-year-old patient underwent total resection of a tumor in the pineal region and histopathology revealed a mature cystic teratoma. Four years later, the patient experienced a recurrence of the suprasellar tumor, which occurred several times over the next eight years. The tumor was successfully eliminated after multiple surgeries, radiotherapy and chemotherapy. By the time the paper was submitted, the patient had not had a recurrence of the tumor and was in the good physical condition and leading a normal life. Based on this case, we discussed the pathogenesis of recurrent mature teratoma and the therapeutic strategy of multiple recurrent GCTs.
PubMed: 36816946
DOI: 10.3389/fonc.2023.1094231