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Respiratory epithelial cysts are rare orbital cysts that can arise secondary to choristomatous rests of respiratory epithelium. Approximately 15 congenital cases have been described in the literature, making it a rare disease entity. We present a case of a 14-month-old Middle Eastern male with a right infraorbital respiratory epithelial cyst. Magnetic resonance imaging of the brain and orbits revealed a right infraorbital cyst hyperintense on T1-weighted images and followed fluid density on T2-weighted images. This cyst was noted to displace the globe superiorly and inferior rectus muscle laterally. This cyst was excised using a transconjunctival approach. Histologically, the cyst wall was lined by ciliated columnar cells with interspersed mucus-containing cells and ciliated transitional epithelium was present, establishing the diagnosis of respiratory epithelial cyst. To our knowledge, this is the youngest patient with a respiratory epithelial cyst of the orbit reported in the literature.

The hepatocellular cancer calvarial metastasis is a rare condition that commonly presents cranial swelling. Therefore, calvarial swelling may confuse with frequent lesions of the scalp. The authors' patient was operated as trichilemmal cyst. But, intracranial extension was seen in operation. Calvarial metastasis of hepatocellular cancer was observed by examination of the patient.

A combination of trauma and a missed inflammatory response (nasal operation) concomitant with hydrocephalus and tumor in secondary encephalocele has not been described in the English literature yet. A 38-year-old man was admitted to the clinic with rhinorrhea that started 3 months ago. In his medical history, nothing abnormal was present except a nasal operation performed 1 year ago. Brain magnetic resonance imaging depicted left frontal encephalocele concomitant with obstructive hydrocephalus caused by an epidermoid cyst originated from the pineal region. A 2-staged surgery was planned. In the first stage, a ventriculoperitoneal shunt insertion was conveyed successfully. In the second-stage surgery, the herniated brain tissue was excised, and the frontal sinus was cleansed with serum saline combined with antibiotic. The bony defect and the dura defect were repaired. The patient's presenting complaint recovered fully, and he was discharged to home in a well condition. Acquired encephalocele is a rare entity. In case of rhinorrhea and encephalocele, even in the presence of prior history of nasal surgery, intracranial evaluation should be conveyed to exclude the presence of hydrocephalus and/or tumor. The cranial defect should be repaired to prevent future infections and brain tissue damage.

Epidermoid cyst located in cranium is uncommon and usually diagnosed with a growing mass leading to symptoms. Asymptomatic intradiploic epidermoid cyst has not been reported yet. In this study, incidental diagnosis of asymptomatic cyst and potential impact of that cyst on surgical planning of a patient with craniosynostosis are presented.

Epidermoid cysts are rare benign tumors that constitute 0.3% to 1.8% of all intracranial tumors. They are inclusion tumors that include epidermoid elements and are most commonly located in the cerebellopontine angle cistern and the parasellar region, and their location in the diploic space is very rare. These lesions slowly grow and usually do not involve the intracranial compartment. In this article, a case of giant epidermoid cyst located in the left frontal intradiploic space is presented with clinical, radiologic features and surgical treatment.

Epidermoid cysts are rare benign tumors that are derived from the development of abnormally situated ectodermal tissue and are often an incidental finding. They are usually diagnosed between 15 and 50 years of age, with both sexes equally affected. In epidermoid cyst management, complete excision is the therapy of choice. The authors reported a case of a 24-year-old man with an epidermoid cyst located on the left side of the face, on the region of mandibular body, which was treated by complete surgical excision. The patient has been followed up for 2 years without signs of recurrence.

Intracranial epidermoid cysts constitute about 1% of all intracranial tumors. They are usually congenital in origin and are thought to derive from ectodermal cell inclusions occurring during closure of the neural tube. Twenty-five percent of these are found in the skull as intradiploic epidermoid cysts. These intradiploic cysts are usually congenital, slow growing, and can grow to large size without causing symptoms. We present a case of intradiploic epidermoid cyst of frontal bone developed due to childhood trauma. The cyst expanded and eroded the walls of the frontal sinus causing proptosis, diplopia, and restricted eye movements with frontal headache. The bicoronal flap approach was used for complete removal of the cyst. Complete removal of the cyst wall is necessary to avoid recurrence.

A 50-year-old man presented with a rare giant crossing cranium-temporal combined epidermal cyst. Physical examination found left facial numbness and temple severely numbness with light pressure. Horizontalis craniocerebral computed tomography demonstrated a mass lesion of 3.0 × 2.0 cm in the middle cranial fossa area; sagittal craniocerebral magnetic resonance scanning demonstrated a mass consisting of 2 leaves (the upper one, 4.0 × 3.0 cm; the lower one, 2.0 × 1.5 cm). Computed tomography angiography showed that the blood supply of the lesion came from superficial temporal artery and middle cranial fossa artery. The clinical diagnosis was neurilemmoma. Surgery revealed a pearly cyst consisting of 2 leaves (connected by a narrowed bridge located at the articular fossa of temporal bone) was 6 × 3 × 3 cm. Histologic examination disclosed disintegrated keratinizing epithelium layer, keratinizing epithelium layer, and stratified squamous epithelium layer from inner to outer and found no hair follicles or sebaceous gland with the diagnosis of epidermoid cyst. Surgery was successfully performed, and the patient was discharged home with severer left facial numbness relatively and left jaw slight opening. The present case suggests that epidermoid cysts can be seen in any location, even giant crossing cranium-temporal combined lesion, and the blood supply should be considered as a factor judging its pathogenesis.

Trichilemmal cysts are common benign soft tissue tumors that occur in hairy areas, especially the scalp, where they present themselves as solitary masses that could be easily treated by surgical excision followed by pathologic identification. It is unusual to find these benign masses in very large numbers in 1 scalp. In the current article, we describe a 43-year-old woman who presented with 51 scalp masses, some of which recurred after repetitive excisions somewhere else by different surgeons under local anesthesia. These masses involved only the scalp and spared all the face. The patient presented to our clinic for a radical solution to clear her scalp from the unaesthetic look and appearance that forbid her from exposing her head and for hygienic reasons relating to the foul smell of repeated previous recurrences and infections. Her clinical presentation is described, and the suggested differential diagnosis and management for such a patient is discussed.

Epidermal cysts of periorbit and intraorbit are common problems to ophthalmologists, but giant periorbital epidermal cyst is exceedingly rare. Only a few cases have been reported previously. A 62-year-old woman presented with a large right periorbital area mass that resulted in right upper lid complete ptosis and severe gaze limitation in all directions. Visual acuity of right eye was finger count (20/2000). Computed tomography and magnetic resonance imaging revealed a bone-destroying mass involving the lateral side of the right superior orbital limb. Complete surgical removal was performed through skin incision. The superior-lateral orbital limb was reconstructed with bone cement and Leibinger plate. Pathologic examination revealed a giant epidermal cyst (9.8×5.2×4.0 cm) of the periorbital area. After surgery, there was near-complete resolution of ptosis and gaze limitation. In addition, marked elevation of visual acuity was observed (20/125 on best-corrected visual acuity).

Epidermal inclusion cyst (EIC) is a benign cyst filled with keratin fibers, which can develop in any part of the body. It is commonly seen in the skin, especially on the face, scalp, neck, and trunk, and has the tendency to slowly grow toward deeper epidermis parts and to cause cystic expansion. Epidermal inclusion cysts are not common in mucosal sites such as the larynx; however, these can arise owing to squamous metaplasia of the glands. We present a 52-year-old man with a laryngeal EIC. This is a very rare case in the literature of EIC in the larynx.

Intradiploic epidermoid cyst is a benign lesion that is derived from the ectodermal cells of the cranium. It is a rare tumor, representing less than 1% of all primary intracranial tumors. It can be located in any part of the skull, but frontal and parietal bones are the most common sites for the cysts. It occurs from the first to the seventh decade of life. Because it is a slowly growing tumor, it is usually discovered incidentally and may remain asymptomatic for many years. Rarely, it grows intracranially to produce brain compression or undergo malignant change. For treatment, it is important to completely remove the capsule of the cysts to avoid recurrence. I describe a 25-year-old man with an intradiploic epidermoid cyst of the temporal bone, who underwent tumor removal and simple mastoidectomy. I also describe the unique radiologic findings of my case, which differed from those of cholesteatoma.

Epidermoid cyst of the external auditory canal (EAC) is rarely encountered in the clinical practice, but when it occurs, it may cause obstruction of the meatus that necessitates surgical excision. The aims of this study were to present 9 pediatric patients with epidermoid cysts of the EAC and to evaluate the outcome of the surgical technique that has been used in excision. Surgical removal of the cyst was carried out through a simple transmeatal approach, a medially based rectangular skin flap was elevated and the cyst was completely removed. No complications or recurrence have been reported. Epidermoid cyst should be listed in the differential diagnosis of EAC masses; it appears on computed tomography as a cystic mass in the outer cartilaginous part of EAC that is usually limited to the soft tissue with no bone erosion. It can be removed easily through simple transmeatal approach with high success rate and no morbidity.

Trichilemmal cyst (TC) is an adnexal skin tumor that usually occurs on the scalp. There is a female dominance in this tumor. Proliferating pilar tumors or cysts arise from this lesion, and the clinical differential diagnosis from TCs must be taken because of aggressive behavior of proliferating pilar tumor. Trichilemmal cyst usually occurs in hair-bearing areas such as the neck, trunk, groin, and others. In this article, we report a case with giant TC involving the neck region.

Pleomorphic adenoma (PA) is a rare tumor of the skin that may arise from either the apocrine or the eccrine glands. Only 4 cases of PA in the auricle have been reported. We experienced the case of a 40-year-old woman who had a slowly growing, nontender auricle mass for 3 years. Under a clinical diagnosis of an epidermal inclusion cyst, we performed a total excision of the tumor with the skin and with direct closure. No recurrence was found during the 18 months of postoperative follow-up. Histologic examination confirmed a diagnosis of PA. Hematoxylin-eosin stain showed tubules that were lined with 2 layers of epithelial cells. The stroma was composed of the myxoid and chondroid matrices. Immunohistochemical staining was positive for cytokeratin, epithelial membrane antigen, and gross cystic disease fluid protein, whereas it was negative for S-100 and carcinoembryonic antigen. These findings suggested that this tumor originated from the apocrine glands. Only a few cases of PA in the auricle have been reported in the literature, 2 of which occurred in the helical rim. Recurrence is rare if there is complete resection of the tumor along with the surrounding capsule. We report herein a rare case of PA that developed in the auricle.

Epidermoid tumors located in the fourth ventricle are exceedingly rare, and the patients usually present with headaches, vertigo, and/or disequilibrium. We discuss the management of orbital floor and lateral wall fracture in a patient who was also incidentally diagnosed to have a large fourth ventricular epidermoid cyst. Although because of their availability and ease of use many allografts have been described, when available, the use of similar membranous bone of equivalent thickness makes the bone graft ideally suited for reconstruction of the orbital floor.

Epidermal inclusion cyst is one of the common benign soft tissue tumors, and it can be easily confirmed and treated by surgical excision. We experienced a patient who had multiple masses on the face and scalp region, and the masses had been misdiagnosed as neurofibromatosis because of accompanying mental retardation. We would like to introduce a case of clinical diagnosis error caused by the lack of radiologic evaluation and pathologic confirmation. A 27-year-old male patient visited with multiple masses, with a length of approximately 1 to 10 cm on the face and scalp region. These mass have developed since childhood without known etiology, and there has been no histologic examination or surgical excision done in the past. The patient's history of seizure disorder and mental retardation led the primary clinician to diagnose it as neurofibromatosis in the initial stage, and therefore, the clinician gave an advice on the possibility of frequent recurrence to the patient. As the masses increased in size, the patient came to our hospital after all. We found that the masses were soft and mobile through the physical examination, and magnetic resonance imaging showed evidence of epidermal inclusion cyst, which is distinguished from neurofibromatosis. Based on physical examination and magnetic resonance imaging, we performed total excision and biopsies. On the histologic examination, it was diagnosed as an epidermal inclusion cyst showing keratotic material internally, and the cyst wall was composed of lamellate keratin. The follow-up period was 12 months, and a recurrence has not occurred. The wound was healed without any specific complication, and both the patient and the guardian were satisfied with the physical enhancement. We have observed a misdiagnosed case that was misconceived by the situation, accompanying mental retardation. Due to this misconception, any surgical treatment was not performed at all, and the symptoms eventually worsened as multiple huge epidermal inclusion cysts. We present this case with a brief review of literature.