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Wei Y, Chen P, Wu H. Gigantic occipital epidermal cyst in a 56-year-old female: A case report. World J Clin Cases 2024; 12:1169-1173. [PMID: 38464927 PMCID: PMC10921299 DOI: 10.12998/wjcc.v12.i6.1169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/12/2024] [Accepted: 02/02/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Gigantic epidermal cysts (GECs) are rare benign skin appendicular tumours also known as keratinocysts. GECs have a high incidence and their wall is made up of epidermis. Epidermal cysts can occur in any part of the skin; clinical manifestations include skin colour hemispherical swelling; cystic; mobile; 0.5 cm to several centimetres in diameter; and slow growth. CASE SUMMARY Herein, we report a case involving a 56-year-old female with a GEC in the occipitalia. On July 25, 2023, a patient with a GEC was admitted to the neurosurgery Department of the Second Affiliated Hospital of Xi'an Medical University. The phyma was shown to be a solid mass during the operation and was confirmed to be a GEC based on pathological examination. CONCLUSION Epidermal cysts are common cystic nodules on the surface of the body, the aetiology is unclear, the clinical manifestations can vary, and the misdiagnosis rate is high. However, giant epidermal cysts are rare. In most cases, however, the prognosis is satisfactory. This paper analyses and summarizes the population, location, clinical and pathological characteristics and pathogenesis of the disease to strengthen the understanding of this disease and improve the accuracy of clinical diagnosis.
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Affiliation(s)
- Yao Wei
- Department of Neurosurgery, The Second Affiliated Hospital of Xi’an Medical University, Xi'an 710038, Shaanxi Province, China
| | - Peng Chen
- Department of Neurosurgery, The Second Affiliated Hospital of Xi’an Medical University, Xi'an 710038, Shaanxi Province, China
| | - Hao Wu
- Department of Neurosurgery, The Second Affiliated Hospital of Xi’an Medical University, Xi'an 710038, Shaanxi Province, China
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Kimolo M, Mbwambo OJ, Seif M, Mbwambo JS, Mremi A, Mteta AK, Bright F, Ngowi BN. Giant perineal epidermoid cyst in adult man: a rare case report and review of literature. J Surg Case Rep 2023; 2023:rjad243. [PMID: 37255952 PMCID: PMC10226807 DOI: 10.1093/jscr/rjad243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 04/10/2023] [Indexed: 06/01/2023] Open
Abstract
An epidermoid cyst is a common benign cutaneous mass that mostly occurs on the neck, face and trunk. The majority of epidermoid cysts are small and asymptomatic with the giant perineal epidermal cyst being rare and more liable to develop complications such as malignant transformation. The treatment of an epidermal cyst involves total excision of the cyst along with its wall to prevent recurrence. We present an unusual case of a giant perineal epidermal cyst in a 52-year-old male.
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Affiliation(s)
- Mathias Kimolo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
| | - Orgeness Jasper Mbwambo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010 Moshi, Tanzania
| | - Mshangama Seif
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
| | - Jasper Said Mbwambo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010 Moshi, Tanzania
| | - Alex Mremi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
- Department of Pathology, Kilimanjaro Christian Medical Centre, PO Box 3010 Moshi, Tanzania
| | - Alfred Kien Mteta
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010 Moshi, Tanzania
| | - Frank Bright
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010 Moshi, Tanzania
| | - Bartholomeo Nicholaus Ngowi
- Correspondence address. Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania. E-mail:
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Liu M, Liu X, Wang Y, Wang Z, Tuo H, Feng Y, Zheng Y. Epidermal Cyst on the Scalp Induced by Forceps Injury During Delivery: A Case Report and Epidemiological Analysis of 3949 Patients. Clin Cosmet Investig Dermatol 2023; 16:593-601. [PMID: 36919012 PMCID: PMC10008422 DOI: 10.2147/ccid.s399372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/01/2023] [Indexed: 03/11/2023]
Abstract
Background Epidermal cysts are common benign epithelial tumors. They are known to result from penetrating-type injuries or infection of human papillomavirus. The differential diagnosis commonly includes multiplex steatocystoma, lipoma, and neurofibroma. Pathological examination is essential for diagnosis, and surgical excision is the recommended treatment. Objective We report a case in a man who presented with a cystic lesion on the scalp over 22 years to provide clinical evidence for mechanism of epidermal cysts. We conducted epidemiological analysis of 3949 patients with epidermal cysts to clarify the epidemiological characteristics and clinical features of epidermal cysts. Patients and Methods A total of 3949 individuals with confirmed epidermal cysts were collected for analysis. Data were expressed as mean ± SEM and analyzed using Student's t-test. Results Our data showed that the mean age of diagnosis of males was statistically earlier than that of females (P<0.001), but no significant difference in sex predilection was observed (P=0.55). The high incidence age of males and females was in the young and middle stage. Lesion locations were a bit different among age groups, but the face was the most common site of epidermal cyst at all age stages. Conclusion Our case offers clinical evidence to the theory which refers trauma as one of the main causes of epidermal cysts in hair-bearing area. According to analysis of large number of samples, we can further support the idea that epidermal cyst has equal sex predilection and mainly occurs on the young and middle-aged adults. It is usually solitary and most likely to be found on face and trunk.
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Affiliation(s)
- Meng Liu
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xinyi Liu
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yuqian Wang
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Ziyang Wang
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Huihui Tuo
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yiguo Feng
- Department of Dermatology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yan Zheng
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
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Lee KI, Namgoong S, You HJ, Jeon TS. Epidemiological characteristics and importance of lobulation of giant epidermal cysts: An 18-year retrospective review of 19 cases. Medicine (Baltimore) 2022; 101:e29978. [PMID: 35945748 PMCID: PMC9351876 DOI: 10.1097/md.0000000000029978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Giant epidermal cysts, which have a diameter of ≥5 cm, have rarely been reported. Giant epidermal cysts that have multiple lobules are referred to as multilocular giant epidermal cysts. This study aims to establish the epidemiological characteristics and statistically determine the significance of lobulation in giant epidermal cysts. Data on 19 patients who developed giant epidermal cysts between January 2003 and February 2021 were retrospectively reviewed. Patients were divided into 2 groups based on the presence of septa and the differences in characteristics were analyzed. Among the 19 patients, 16 (84.2%) were male, and the mean age was 57.7 ± 10.6 years. The mean patient-reported tumor duration was 14.8 ± 12.5 years. Seven (36.8%) patients had multilocular giant epidermal cysts, whereas 12 (63.2%) had unilocular giant epidermal cysts. Compared with unilocular giant epidermal cysts, multilocular giant epidermal cysts had a significantly larger mean diameter (6.0 ± 0.7 vs 8.2 ± 1.8 cm, P = .02) and estimated volume (91.8 ± 43.3 vs 250.0 ± 157.0 mL, P = .02). Giant epidermal cysts have distinctive epidemiologic characteristics with predominance among males, those in their 50s, and a long tumor duration. Multilocular giant epidermal cysts are significantly larger in diameter and volume than unilocular ones.
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Affiliation(s)
- Kyu-Il Lee
- Department of Plastic Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sik Namgoong
- Department of Plastic Surgery, Korea University College of Medicine, Seoul, Republic of Korea
- * Correspondence: Sik Namgoong, MD, PhD, Department of Plastic Surgery, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (e-mail: )
| | - Hi-Jin You
- Department of Plastic Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - Tae-Sung Jeon
- Department of Pathology, Korea University College of Medicine, Seoul, Republic of Korea
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Yagmur I, Tekin A, Bağcı U, Yaman B, Avanoglu A, Ulman I. Acquired Penile Epidermoid Cysts in Children. Cureus 2022; 14:e27462. [PMID: 36060345 PMCID: PMC9420546 DOI: 10.7759/cureus.27462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 11/21/2022] Open
Abstract
Background In this study, we aim to present the experience of a tertiary center regarding penile epidermoid cysts over 15 years. Methodology Patient files of those who underwent surgical excision for penile epidermoid cysts between 2005 and 2019 were reviewed retrospectively. The demographics, clinical characteristics, etiological factors, cyst features, surgical techniques, complications, and follow-up data were analyzed. Results In total, 24 penile epidermoid cysts were excised in 21 boys. The median age at the time of surgery was 52 (15-204) months. The median duration between previous surgery and cyst excision was 40 (1-180) months. In total, 11 cases had a history of circumcision, and 10 had undergone hypospadias surgery. There was no significant difference between these two etiologic groups (p > 0.05). The main symptom was an asymptomatic penile mass. The average cyst size was 9.4 ± 6.7 mm. All cysts were completely excised with incisions made over old scars, except one. No complications were observed during a median follow-up period of 50 (12-120) months, and only one recurrence was noted. Conclusions Acquired penile epidermoid cysts may present as an early or late complication after penile surgery. Complete excision with an incision along the existing scars seems to be an effective solution for preventing new scars.
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Gupta R, Verma P, Bansal N, Semwal T. A Case of Ruptured Perineal Epidermal Cyst. Cureus 2020; 12:e11099. [PMID: 33240695 PMCID: PMC7681750 DOI: 10.7759/cureus.11099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Epidermal cysts are common skin lesions. They are usually seen in the chronic sun-exposed areas of the skin. They can get complicated by inflammation, infection, rupture, or malignancy. Epidermal cyst in the perineal region is rare. We report a case of an infected ruptured perineal epidermal cyst mimicking gluteal abscess. The patient was successfully treated by complete surgical excision. Histology revealed epidermal cyst with foreign body giant cell reaction and no evidence of malignancy.
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Affiliation(s)
- Rahul Gupta
- Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, IND
| | - Piyush Verma
- Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, IND
| | - Nalini Bansal
- Department of Histopathology, Fortis Escorts Heart Institute, New Delhi, IND
| | - Tushar Semwal
- Radiology, Synergy Institute of Medical Sciences, Dehradun, IND
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Vale J, Pang Y, Kumpf A, Fitkin D, Drew S. Case report of squamous cell cancer arising in perineal epidermal inclusion cyst, presenting as rapidly enlarging and cavitating lesion. Int J Surg Case Rep 2018; 53:115-119. [PMID: 30391735 PMCID: PMC6216085 DOI: 10.1016/j.ijscr.2018.10.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 10/08/2018] [Indexed: 11/19/2022] Open
Abstract
Perineal inclusion cysts may harbor clinically occult malignant degeneration. Histological analysis of large inclusion cysts required to rule out occult malignancy. Perineal cysts with malignant degeneration are diagnostic, reconstructive challenge. Risk of malignancy in perineal inclusion cysts helps treatment decisions. Large perineal cyst requires multidisciplinary surgical team for excision and closure. Colostomy as adjunct of perineal reconstruction after excision of inclusion cyst. Perineal inclusion cysts may present as atypical, cavitating lesions.
Introduction Cutaneous squamous cell cancer (cSCC) is a common condition, with straight forward and well-known heuristics regarding diagnosis, treatment, and surveillance. cSCC arising in an epidermal inclusion cyst is rare, but not unheard of. In contrast, the authors’ are unaware of any prior reports of cSCC arising in an epidermal inclusion cyst within an atypical cavernous and cavitating lesion in the perineum. Presentation of case A 48-year-old male presented with a cavitating and rapidly growing cutaneous perineal lesion. Preliminary diagnostic procedures (biopsy) showed benign pathology and imaging showed no involvement of perineal organs such as prostate or rectum. Discordance between initial diagnostics and clinical features prompted multi-specialty consultation, including dermatological pathology. Repeat biopsy yielded in situ, possibly invasive squamous cell cancer, arising in the background of an epidermal inclusion cyst. Wide excision with advancement flap reconstruction was employed, with temporary diverting colostomy to avoid perineal sepsis. Discussion Location and appearance of this lesion provided a diagnostic and treatment challenge requiring multi-specialty involvement for diagnosis and successful treatment. Specialists from urology, general surgery, dermatology, general and dermatological pathology, plastic and reconstructive surgery, colorectal surgery and medical and radiation oncology were involved in diagnosis, treatment plan and execution. None of the specialists involved had seen this singular presentation before, and this created an ownership and management challenge. Conclusion The cavitating, atypical appearance of lesion complicated diagnosis. Location required pre-treatment coordination and deliberation between dermatology, urology, general surgery, and plastic surgery. Malignant degeneration of inclusion cysts, although rare, has to be kept in mind, especially when presenting with rapid growth, and persistence in ruling out malignant diagnosis is fundamental.
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Affiliation(s)
- Jose Vale
- General Surgery, OhioHealth Marion Medical Campus, Marion Medical Campus, 1040 Delaware Avenue, 43302 Marion, OH, USA.
| | - Yijun Pang
- Anatomic and Clinical Pathology, OhioHealth Marion Area Physicians, Marion Medical Campus, 1040 Delaware Avenue, 43302 Marion, OH, USA.
| | - Arthur Kumpf
- Plastic and Reconstructive Surgery, OhioHealth Marion Area Physicians, Marion Medical Campus, 1040 Delaware Avenue, 43302 Marion, OH, USA.
| | - David Fitkin
- Urology, OhioHealth Marion Area Physicians, Marion Medical Campus, 1040 Delaware Avenue, 43302 Marion, OH, USA.
| | - Scott Drew
- Dermatology, OhioHealth Marion Area Physicians, Marion Medical Campus, 1040 Delaware Avenue, 43302 Marion, OH, USA.
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