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Cutaneous cystic lesions (n = 35) were examined with optical coherence tomography. Cysts were visible as a hyporeflective roundish area with a clear margin; in some cases, the epidermis was thinned. Epidermal cysts, trichilemmal cysts, and hidrocystomas had a linear margin representing the epithelium of the cyst, whereas mucoid pseudocysts showed no linear margin. Trichilemmal and epidermal cysts presented with hyperreflective content that corresponds to keratin. By visualizing the margin and the content of the cyst, it was possible to differentiate between different types of cysts., (© 2023. The Author(s).)

Epidermoid cysts of the parotid gland are rare. We report the case of a 60-year-old man with a cystic tumor of the right parotid gland. The patient had undergone ipsilateral middle ear surgery twice four years previously. The tumor was identified by computed tomography and ultrasonography and removed by total parotidectomy under suspicion of a parotid tumor. Histopathology revealed the diagnosis of an epidermal cyst. The differential diagnosis of a parotid tumor should include (iatrogenic) epidermoid cyst, in particular if there is a history of prior ear surgery via an endaural approach.

In contrast to epidermoid cysts of the dermis, epidermoid cysts of the kidneys are rare. We report on a female patient with recurrent renal colic caused by an epidermoid cyst of her right kidney. A malignant tumor was suspected by computed tomography but was ruled out through ureterorenoscopic biopsy. The epidermoid cyst was removed by a partial nephrectomy.

The patient presented here suffered from a tumor of the frontal part of the neck and from position-dependent dyspnea. He had a history of tracheostomy following vascular surgery; the tracheostomy did not close spontaneously, so it needed to be sutured. The tracheostomy channel seemed to have developed spontaneous epithelization. After its closure, an epidermoid cyst developed from the epithelium. This cyst was the cause of the patient's symptoms, and it was surgically removed.

Background: The growth of dysontogenetic cysts at the floor of the mouth is considered as a rare condition. Cysts of the floor of the mouth may be differentiated depending on location or on histopathologic-embryological criteria into dermoids, epidermoids and teratomas., Patients and Methods: We report a case of a large cyst at the floor of the mouth and present the results of clinical examination, preoperative diagnostics and surgical approach., Results: The tumour was resected by an enoral operation. Histological findings confirmed a large sublingual epidermoid cyst. There were no complication or relaps during postoperative course. The case is discussed within the framework of scientific literature., Conclusions: Dysontogenetic cysts should be considered in differential diagnosis of tumours of the floor of the mouth. Diagnostic and surgical management depends first of all on size and location of dysontogenetic cysts.

Tumor-like bone lesions include various conditions of a non-neoplastic nature originating from or affecting the bone as solitary or sometimes multiple bone lesions. This review discusses the most important cystic tumor-like lesions, such as simple bone cyst, aneurysmal bone cyst, intraosseous ganglion, epidermoid cyst and subchondral cyst. MR is the most sensitive method of detection, and is the most accurate in depicting the extent of involvement of these lesions. MR signal characteristics may aid in differential diagnosis. Conventional radiographs are often more specific with respect to the underlying histopathology.

History and Findings: A 37-year-old woman was admitted with an ulcerated tumor of the scalp together with an enlarged cervical lymph node. The clinical features resembled proliferative trichilemmal cyst., Investigations: Fine needle aspiration of the lymph node revealed an amelanotic metastasis of a malignant melanoma., Treatment and Course: The entire tumor was removed and a radical neck-dissection performed. Histopathological examination confirmed the diagnosis of metastatic malignant melanoma., Conclusion: Proliferative trichilemmal cysts and malignant melanoma of the scalp are rare, but should be considered as differential diagnoses of neoplasm in this part of the body.

CT and MRI of acquired abnormalities of the inner ear and cerebello-pontine angle present themselves with very typical findings. The imaging should be adapted to the pathology looked for and either CT or MRI should be used alone or in combination. CT, especially high resolution CT (HRCT), provides an excellent bone contrast, while MRI has a much superior soft tissue contrast. Acute inflammatory changes of the inner ear are solely depicted by contrast-enhanced MRI. HRCT excellently depicts osseous changes of the inner ear and cerebellopontine angle such as chronic ossifying labyrinthitis occurring after acute labyrinthitis, otosclerotic or traumatic changes. Tumorous changes not yielding to bony changes are best delineated by MRI. Posttraumatic hemorrhage and chronic fibrotic changes within the labyrinth are depicted by MRI, only. In conclusion HRCT and MRI are excellent methods to delineate acquired abnormalities of the inner ear and cerebello-pontine angle. HRCT best depicts osseous changes while MRI best depicts soft tissue changes. HRCT and MRI are not concurrent methods but should better be used as complementary methods for imaging acquired abnormalities of inner ear and cerebellopontine angle.

Intracranial epidermoids are primarily extracerebral congenital cysts. Intra- and extradural types are differentiated: intradural lesions originate in the intracranial CSF spaces, and extradural lesions in the bony skull. Epidermoids increase in size passively as the result of an increase in the cyst volume and not because of active growth. Clinically epidermoids behave like benign, slow-growing cerebral tumours. Differential diagnosis includes other cysts and cystic tumours. Neuroradiologically epidermoids present as polycystic lesions showing extensive growth in the extracerebral CSF spaces and secondary invagination of the brain. On CT and MR, despite the high cholesterol content, epidermoids show the characteristics of liquor and not those of fat. It can be shown that the typical CT and MR appearance of an epidermoid is due to the different proportions of CSF in the cyst content, which results from diffusion or dehiscence of the cyst capsule. The present study was based on analysis of 6 cases selected from a total of 29 patients with CNS epidermoids.

Twenty-one patients with skin tumors were examined before and after operation using special high-frequency ultrasound B-scanners. The different histological types were related to sonographic phenotypes, and the extent of tumors in the ultrasound image was comparable with that seen on the histometric image. The extent and invasion depth of skin tumors were assessed correctly by ultrasound.

An extensive epidermoid cyst in the posterior fossa was diagnosed in a 59 year old male patient. The most valuable indicator for differential diagnosis was given by plain skull x-ray showing a peripheral zone of sclerosis as the leading x-ray sign of epidermoids. CT and MRI complemented the preoperative diagnostic measurements.

Cysts are rare lesions of the spleen, and may be divided into parasitic and non-parasitic types. After the parasitic cysts, the second most frequent group is the (secondary) posttraumatic form of non-parasitic cysts. The primary form (congenital and neoplastic) of the latter is the least frequent. Whereas splenectomy was the treatment of choice for lienal cysts until a few years ago, a change has occurred in the techniques of splenic salvage. Against the background of a case report of a primary epidermoid cyst the etiology, diagnostic measures, and the recent developments in conserving spleen surgery are discussed.

20 patients (9 women, 11 men) were operated on because of dysontogenetic tumour in the spinal canal. The average age at the time of operation being 23 years. 9 patients already showed an incomplete transverse lesion with a mean duration of the disease being 51 months. After the operation 15 patients showed an improvement. 12 patients became again fit to work. Two patients are in need of care. Within a after-observation period of three years one patient died.

The authors discuss 21 epidermoids and 6 dermoids of the craniocerebral region, which occurred in patients of the Leipzig Neurosurgical Clinic within a period of ten years. Main localisation was the sellar region. The clinical symptoms (frequently with lacking signs of brain pressure), the diagnosis and prognosis of the malformation tumours are dealt with.

After a short description of the pathogenesis and morphology of intracranial epidermoids, the clinic symptoms and the diagnosis are dealt with. Therapeutically, it is exclusively a total extirpation with the use of a surgical microscope that can lead to curing. A report is given on nine patients, eight of whom were successfully operated on. It is hardly possible to establish a founded preoperative diagnosis of the kind of the epidermoid. Hypodense space occupying processes in the computer tomogram should, however, give rise to consider differentialdiagnostically also the presence of epidermoids.

A case of pearly tumor (cholesteatoma or epidermoid cyst) of the IV. ventricle in a patient aged 64 years is reported. The patient had been treated one year earlier for lumbar herniated nucleus pulposus. The symptoms, pathogenesis, CT-appearance and operative therapy of the cyst are discussed.

Between 1966 and 1974, 1260 lidtumours were sent to the histological laboratory of the University Eye Hospital Hamburg. The clinical diagnosis "chalazion" in 138 cases could not be verified histologically in 33 cases. Other benign lesions were diagnosed 23 times and malignant lesions in 10 cases (4 times a Meibom's sebaceous cell carcinoma). The symptoms of all 7 Meibom's sebaceous cell carcinomatas diagnosed histologically during this time (the most common metastasizing lid-tumor in this series) were also analysed as they present the gravest diagnostic error for chalazia. Histologic examination of excised "chalazion"-material must be considered mandatory in all patients with a typical symptomatology, recurrence at the same site, high age, unilateral therapy-resistant keratoconjunctivities and involved regional lymphnodes.

MR images were obtained in 15 patients with cystic lesions in the posterior fossa and the results compared with computed tomography (CT). The abnormalities imaged included 5 epidermoids, 3 haemangioblastomas, 4 arachnoid cysts, 1 postoperative cyst, and 4 large cisterns. One advantage of MR is the ability to demonstrate lesions in three planes and without artifacts. Liquor-related intensity measurements of cyst contents provided important information, thereby improving diagnostic specificity and patient management. T2-weighted images were found to be more sensitive in characterising cystic lesions of the posterior fossa than were T1-weighted images. Large cisterns, arachnoid and postoperative cysts had an intensity pattern identical or almost identical to cerebral spinal fluid. More proteinaceous cysts, including epidermoids and to a higher degree haemangioblastomas, had clearly higher intensity than cerebral spinal fluid on the T2-weighted images.

Two patients are described in whom steatocystoma multiplex conglobatum presented as recurrent axillary abscesses. This disease entity is rare and can easily be confused with hidradenitis suppurativa or acne conglobata.

In times of increasing "sparetime pathology" sequels of sports are getting a new meaning in medicine. Surgeons are mainly involved in this issue but it also contacts neurologists. We differentiate between direct sequels of sports and concomitant incidents of sports. Besides the typical head injuries we saw a number of atypical traumatic damages such as a hit by a golf ball, fall on the buttocks and the header in football. Discprotrusions are mainly understood as concomitant incidents at sports because in most cases one has to consider preexisting disc lesions. Though there are typical motions in sports which rather lead to discprotrusions such as strong torsions of the body in football, serving in tennis, heavy lifting in wrestling or an unexpected fall into a hollow in skiing. In cerebrovascular events, sports is usually only one additive etiological component. Nevertheless the lack of adequate acclimatisation and the brisk beginning of stressing sports in high mountain areas (which is enabled through modern technic) can contribute a great deal to decompensation of cerebrovascular disorders. In this respect doping can have a serious influence since protecting physiological mechanisms are eliminated. Diving accidents are able to give rise to spinal, cerebral and cerebellar gasembolisation. Warning early symptoms of great value are TIA, vertigo and fits. Sport practice can figure as an unspecific test situation in order to provoke these events. Diagnostic investigation of the cardiovascular system and the CNS has to be performed in those cases. Particular regard should be paid to expert situations which tend to distort the clinical pictures.(ABSTRACT TRUNCATED AT 250 WORDS)

Occlusions or obstructions in the region of the interventricular foramen (also known as foramen of Monro) can be due to a variety of causes. Among these are lesions of the hypothalamus that can be operated on under present-day conditions and in certain cases. This article draws attention to the possibility of choosing between several surgical approaches. Analysis of our own material (27 cases) during the past ten years shows that good results can be obtained when using modern methods of diagnosis and treatment. Four case reports are presented of four typical patients with occlusion of the foramen of Monro. If there is an associated hydrocephalus, the transcortico-transventricular approach appears to be the most appropriate one. It seems it is not always possible to effect exact type-specific separation of the diseases in the third ventricle. The presence of blood in the CSF can be a pointer toward a tumour in the third ventricle.

The clinical and histopathological picture of the pigmented epidermal cyst and the pigmented trichilemmcyst is illustrated by three case-reports. The pigment is melanin, which is located in the epithelium of the cyst-wall, the corneocytes of the lumen and in macrophages in the dermis. The clinical appearance of melanin pigmented cysts is blue due to the Tyndall-phenomenon.

Epidermal cysts of the palms and sole of feet are rare. They originate from traumatic implantation of the epidermis into the dermis or subcutis. Three cases (one on the palm and two on the sole of the feet) are reported.

Case report on a large epidermoid cyst in the proximal tibia in a 42-year old woman. Scrutiny of the available literature shows that this is the first recorded case of an epidermoid cyst in a long bone.

This is report of a group of four patients with epidermoid cysts of the testis. The pathogenesis, symptomatology, pathology and therapy of this benign testicular tumor (or tumor like testicular lesion) in these cases, including 150 reported cases in the literature are presented and discussed.