Epidermoid cysts are generally benign neoplastic lesions, the etiology of which is unclear and is mainly related to epithelial cells left in the tissues during the embryonic period and traumatically implanted in the tissues. The most common intraosseous sites are the phalanges and the skull. Epidermoid cysts occurring in the jaws are clinically rare. In this paper, we report a case of epidermoid cyst occurring in the mandible with embedded teeth and discuss the etiology, clinical manifestations, diagnosis, and treatment of epidermoid cysts in the jaws in the context of the relevant literature.
Humans ; Epidermal Cyst/surgery* ; Skull ; Mandible ; Diagnosis, Differential ; Epithelial Cells

Epidermal inclusion cyst of the breast is an uncommon benign lesion and it is usually located in the skin layer. We report here on two cases of ruptured epidermal inclusion cysts in the subareolar area, which is a very unusual location for these cysts and these lesions can be mistaken for breast malignancies.
Adult ; Breast Diseases/surgery/*ultrasonography ; Epidermal Cyst/surgery/*ultrasonography ; Female ; Humans ; Middle Aged ; Rupture/ultrasonography

Splenic epidermoid cysts are relatively rare lesions traditionally treated by splenectomy. Concerns about overwhelming postsplenectomy sepsis have led to the development of splenic preservation procedures in the treatment of cystic diseases of the spleen. Better understanding of the splenic segmental anatomy and advances in laparoscopic skills has made laparoscopic partial splenectomy a preferred treatment for splenic cysts while preserving splenic function. We reported a case of a 30-year-old male patient with a large epidermoid splenic cyst managed successfully by laparoscopic partial splenectomy. The patient recovered well after operation and was asymptomatic on a follow-up of 1 year with no recurrence on ultrasonography and a normal platelet count. Laparoscopic partial cystectomy is an acceptable procedure for the treatment of splenic cysts which locate in the pole of spleen. On the one hand, it cures the disease preserving the splenic tissue without risk of bleeding or recurrence; on the other hand, this minimally invasive technique induces a reduced hospital stay and a more rapid recovery.
Adult ; Epidermal Cyst ; surgery ; Humans ; Laparoscopy ; methods ; Male ; Splenic Diseases ; surgery

OBJECTIVETo summarize the clinical features, diagnostic and therapeutic experiences of presacral developmental cysts.

METHODSClinical data of 22 patients with presacral developmental cysts underwent tumor excision surgery from January 1989 to December 2008 was retrospectively analyzed.

RESULTSIn this group, 8 male and 14 female patients were included with a median age of 29.5 yrs (18 - 72 yrs) at diagnosis. The mean diameter of the cysts was (8.3 + or - 2.7) cm. Of the cases, 6 patients presented with epidermoid cysts, 4 cases with dermoid cysts and 12 cases with teratomas (2 with malignant change). Surgical approaches included the trans sacrococcygeal approach (18 cases), the transabdominal approach (3 cases), and the combined transabdominal-sacrococcygeal approach (1 case). The operative duration and blood loss of each operative approach was as follows: modified Kraske's procedure (142 + or - 43) min/(192 + or - 149) ml, Mason's procedure (102 + or - 27) min/(54 + or - 37) ml, transabdominal procedure (147 + or - 25) min/(117 + or - 76) ml, combined approach 360 min/1000 ml. In the trans sacrococcygeal group, 1 case (6.3%) of intra-operative presacral vein bleeding and 1 case (6.3%) of the surgical incision infection occurred. One case in the combined approach group suffered from incision infection. No significant complication was found in the transabdominal group. The patients were followed up for 9-92 months (mean, 40 months) and meanwhile the tumor relapsed in 2 cases in 20 patients with benign lesions: one patient underwent trans sacrococcygeal surgery and the other received transabdominal surgery.

CONCLUSIONSThe presacral developmental cysts develop slowly with a tendency toward malignancy. And delayed treatment brings much more difficulties to the surgical excision, so it should be radically excised once diagnosed. The trans sacrococcygeal approach is a preferable surgical procedure with direct access, minimal operative injuries and complications; and the combined transabdominal-sacrococcygeal approach could be employed when needed.

Adolescent ; Adult ; Aged ; Cysts ; surgery ; Dermoid Cyst ; surgery ; Epidermal Cyst ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sacrococcygeal Region ; Teratoma ; surgery ; Young Adult

Endoscopy ; methods ; Epidermal Cyst ; surgery ; Female ; Humans ; Middle Aged ; Skull Base ; pathology

A 54-year-old woman presented with a huge palpable mass on left upper quadrant of the abdomen. After preoperative work-up, a cystic disease of pancreatic tail or accessory spleen was initially suspected. We performed exploratory laparotomy and resected both the spleen and a 15 x 11 cm-sized huge cystic mass containing a part of solid component which extended continuously to the pancreatic tail. The solid component, comprising the upper portion of the resected cyst, was reddish brown and granular like as normal splenic tissue. The inner surface of the cyst was smooth and was filled with yellowish white material. Histologic examination showed an epidermoid cyst originating in the accessory spleen of the pancreatic tail lacking hair or skin appendages.
Case Report ; Epidermal Cyst/surgery ; Epidermal Cyst/pathology* ; Female ; Human ; Magnetic Resonance Imaging ; Middle Age ; Pancreas/surgery ; Pancreas/pathology* ; Spleen/surgery ; Spleen/pathology* ; Splenic Neoplasms/surgery ; Splenic Neoplasms/pathology*

Epidermoid tumor of the cavernous sinus is rare. The aim of this case report is to discuss the role of neuroendoscopes in the removal of such lesions. A 21-year-old man presented with 6-year history of progressive headache, diplopia, and visual disturbance. Work-up revealed an epidermoid tumor located in the right cavernous sinus. An extradural transcavernous approach was utilized via a traditional frontotemporal craniotomy with endoscopic assistance. The postoperative course was uneventful with immediate improvement of the patient's headache. Postoperative magnetic resonance imaging demonstrated complete removal of the tumor. There were no signs of recurrence during a 2-year follow-up period. The endoscope is a useful tool for removing epidermoid tumors from the cavernous sinus and enhances visualization of areas that would otherwise be difficult to visualize with microscopes alone. Endoscopes also help minimize the retraction of neurovascular structures.
Adult ; Cavernous Sinus/*pathology/*surgery ; Endoscopy/*methods ; Epidermal Cyst/*pathology/*surgery ; Humans ; Male ; Microsurgery/*methods ; Young Adult

Bone Diseases ; etiology ; surgery ; Chronic Disease ; Epidermal Cyst ; etiology ; surgery ; Femur ; Humans ; Male ; Middle Aged ; Osteomyelitis ; complications

Hemifacial spasm (HFS) is almost always induced by vascular compression but in some cases the cause of HFS are tumors at cerebellopontine angle (CPA) or vascular malformations. We present a rare case of hemifacial spasm caused by epidermoid tumors and the possible pathogenesis of HFS is discussed. A 36-year-old female patient presented with a 27-month history of progressive involuntary facial twitching and had been treated with acupuncture and herb medication. On imaging study, a mass lesion was seen at right CPA. Microvascular decompression combined with mass removal was undertaken through retrosigmoid approach. The lesion was avascular mass and diagnosed with an epidermoid tumor pathologically. Eventually, we found a offending vessel (AICA : anterior inferior cerebellar artery) compressing facial nerve root exit zone (REZ). In case of HFS caused by tumor compression on the facial nerve REZ, surgeons should try to find an offending vessel under the mass. This case supports the vascular compression theory as a pathogenesis of HFS.
Acupuncture ; Adult ; Cerebellopontine Angle ; Epidermal Cyst ; Facial Nerve ; Female ; Glycosaminoglycans ; Hemifacial Spasm ; Humans ; Microvascular Decompression Surgery ; Vascular Malformations

BACKGROUND: Epidermal cysts are benign, slow growing cysts that often develop on the head, neck, chest, and back of adults. The most common method of surgical excision involves the use of a scalpel and often leaves a scar proportional to the size of the cyst. Therefore, minimally invasive techniques are required. Among these techniques, the CO2 laser-based technique is minimally invasive and has lower complication rate, shorter recovery times, and lesser scarring. This paper aimed to compare the results and postoperative complications associated with a CO2 laser-based excision against conventional surgical excision for epidermal cysts. METHODS: We surveyed 120 patients, aged 16 to 65 years, with epidermal cysts on the face measuring 0.5 to 2.2 cm in diameter. Twelve months later, we compared the scar length, recurrence rate, patient satisfaction, and complications between patients treated with CO2 laser excision versus surgical excision. RESULTS: The mean scar length (12 months postoperative) after CO2 laser excision was 0.30± 0.15 cm, and that following surgical excision was 1.23± 0.43 cm (p= 0.001). The procedure time (time from incision after local anesthesia to the end of repair) was 16.15± 5.96 minutes for CO2 laser excision versus 22.38± 6.05 minutes for surgical excision (p= 0.001). The recurrence rates in the surgical excision group and CO2 laser excision group were 3.3% and 8.3%, respectively; this difference was not statistically significant (p= 0.648). CONCLUSION: The cosmetic outcome of CO2 laser excision is excellent. For epidermal cysts measuring 2.2 cm or smaller, CO2 laser excision is recommended, especially when aesthetic outcome is considered important.
Adult ; Anesthesia, Local ; Cicatrix ; Epidermal Cyst ; Head ; Humans ; Lasers, Gas ; Methods ; Neck ; Patient Satisfaction ; Postoperative Complications ; Recurrence ; Surgery, Plastic ; Thorax