Cystic Lesions of the Orbit: Dermoid and Epidermoid Cysts

We aimed to define the diffusion-weighted magnetic resonance (MR) imaging features of intracranial cystic lesions and to investigate possible special features for the differential diagnosis. One hundred and twenty patients with intracranial cystic lesions were included in the study. There were 29 arachnoid cysts, eight epidermoid cysts, 34 primary tumors, 18 abscesses, 29 metastases and two hydatid cysts. Echo-planar diffusion-weighted MR imaging was obtained in addition to conventional cranial MR scans. The morphologic features of the cystic portion and the wall of the cyst and signal intensities on diffusion-weighted images were evaluated. All abscesses and epidermoid cysts were hyperintense on diffusion-weighted images. Arachnoid cysts, hydatid cysts, primary tumors, and metastases were hypointense except five cystic tumors. These five primary or metastatic necrotic tumors showed high signal intensity on diffusion-weighted images due to hemorrhage or superinfection. The walls of the cystic tumors were usually hyperintense on diffusion-weighted images in contrast to the wall of the abscesses, which were iso-hypointense. This was a statistically significant finding for the differentiation between tumors and abscesses (P<0.05). Diffusion-weighted MR imaging is a useful technique for the evaluation of the intracranial cystic lesions and provides additional beneficial information to conventional MR imaging. However, the presence of hemorrhage and superinfection of the tumors may cause a signal increase that results in misinterpretetations. In these cases, the appearance of tumor wall may be useful for differentiating abscesses from tumors.

Download Full-text

Orbital Epidermoid Cysts: A Diagnosis to Consider

Journal of Ophthalmology ◽

10.1155/2014/508425 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Rania A. Ahmed ◽

Rasha M. Eltanamly

Keyword(s):

Clinical Signs ◽

Histopathological Diagnosis ◽

Ocular Motility ◽

Cystic Lesions ◽

Separate Entity ◽

Radiological Findings ◽

Interventional Study ◽

Epidermoid Cysts ◽

Symptoms And Signs

Background. Orbital epidermoids form a rare pathological entity that is separate from dermoid cysts. They have variable clinical and radiological presentations and they should be considered in the differential diagnosis of orbital cystic lesions. This work describes the various clinical and radiological presentations of 17 cases of epidermoid cysts and the surgical outcome.Method. A prospective interventional study was conducted on 17 patients diagnosed with epidermoid cysts. Patients’ symptoms and signs were recorded; CT scan was done for all patients. All lesions were removed through anterior orbitotomy and histopathological diagnosis confirmed.Results. Mean age of patients was 16.3 years± 10.54. Main complaints were lid swelling, masses, ocular dissimilarity, chronic pain, and ocular protrusion. Clinical signs varied from lid swelling and masses in all cases to proptosis, globe displacement, limitation of ocular motility, and scars. Radiological findings ranged from homogenous hypodense masses (58.8%) to homogenous radiolucent (17.6%) and heterogenous masses (23.5%). No recurrences following surgeries were reported throughout the follow-up (mean 18.8 months± 0.72).Conclusion. Deep orbital epidemoid cysts are a separate entity that can behave like deep orbital epidermoid; however, they usually present at a relatively older age. They can be associated with increased orbital volume but not necessarily related to bony sutures.

Download Full-text

Epithelial cystic lesions of the sellar and parasellar region: a continuum of ectodermal derivatives?

Journal of Neurosurgery ◽

10.3171/jns.1994.80.6.1018 ◽

1994 ◽

Vol 80 (6) ◽

pp. 1018-1025 ◽

Cited By ~ 102

Author(s):

Michael J. Harrison ◽

Susan Morgello ◽

Kalmon D. Post

Keyword(s):

Clinical Presentation ◽

Cystic Lesions ◽

Content Type ◽

Epidermoid Cysts ◽

Parasellar Region ◽

Histological Criteria ◽

Rathke's Cleft Cysts ◽

Rathke's Cleft ◽

Epithelial Lesions ◽

Fine Print

✓ Cystic epithelial lesions of the sellar and parasellar region are classified on the basis of histology and location into Rathke's cleft cysts, epithelial cysts, epidermoid cysts, dermoid cysts, and craniopharyngiomas. A retrospective review of the clinical presentation, radiological findings, and histology was performed on 19 such lesions, and a survey of the literature pertinent to the classification, clinical presentation, and embryology of these lesions was conducted. Presentation was nonspecific and not predictive of histology. Imaging studies were generally useful in distinguishing these tumors, with the exception of Rathke's cleft cysts, suprasellar epidermoid cysts, and craniopharyngiomas, which frequently could not be differentiated. On microscopic examination, most lesions fit into distinct categories; however, overlap was common among all and some could not be definitively categorized by histological criteria. Evidence supportive of an ectodermal ancestry for sellar and parasellar epithelial-lined cystic lesions is presented. Based on the current findings and a review of the literature, it is suggested that these lesions represent a continuum of ectodermally derived cystic epithelial lesions.

Download Full-text

Mycosis fungoides with underlying epidermoid cysts

Archives of Dermatology ◽

10.1001/archderm.115.5.622 ◽

1979 ◽

Vol 115 (5) ◽

pp. 622-622 ◽

Cited By ~ 8

Author(s):

L. A. King

Keyword(s):

Mycosis Fungoides ◽

Epidermoid Cysts

Download Full-text

Contribution of MR imaging and CEA cystic fluid level to the differential diagnosis of cystic lesions of the pancreas

Gastroenterology ◽

10.1016/s0016-5085(01)83805-1 ◽

2001 ◽

Vol 120 (5) ◽

pp. A764-A764

Author(s):

M DELHAYE ◽

C WINANT ◽

D DEGRE ◽

B GULBIS ◽

C GERVY ◽

...

Keyword(s):

Differential Diagnosis ◽

Mr Imaging ◽

Cystic Lesions ◽

Fluid Level ◽

Cystic Fluid

Download Full-text

Measurement of both CEA and CA72–4at EUS-FNA of pancreatic cystic lesions may increase sensitivity of diagnosis

Endoscopy ◽

10.1055/s-0031-1292211 ◽

2011 ◽

Vol 43 (S 03) ◽

Author(s):

R Walmsley ◽

M Rodgers

Keyword(s):

Cystic Lesions

Download Full-text

Evolving cystic lesions

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0036-1587923 ◽

2016 ◽

Vol 37 (S 01) ◽

Author(s):

YRE Chean ◽

NA Gazali ◽

SA Uppaluri

Keyword(s):

Cystic Lesions

Download Full-text

Cystic Bone Lesions in Horses and Humans: A Comparative Review

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632602 ◽

1998 ◽

Vol 11 (01) ◽

pp. 08-18 ◽

Cited By ~ 30

Author(s):

C. W. McIlwraith ◽

J. A. Auer ◽

Brigitte von Rechenberg

Keyword(s):

Recurrence Rate ◽

Subchondral Bone ◽

Fibrous Tissue ◽

Clinical Signs ◽

Bone Lesions ◽

Anatomical Location ◽

Cystic Lesions ◽

Bone Cysts ◽

Biological Behaviour ◽

Comparative Review

SummaryCases of cystic bone lesions in horses and humans were reviewed in the literature. These lesions are radiolucent areas of bone, recognized as subchondral cystic lesions in the horse (SCL), intra-osseous ganglia (IOG), subchondral bone cysts secondary to osteoarthrosis (OAC), and unicameral bone cysts (UCB) in humans. Their morphology is quite similar, consisting of lesions with a distinct cyst wall, and a cavity filled with fibrous tissue and yellowish mucoid fluid. The lesions are surrounded by sclerotic bone and can be easily diagnosed radiographically. SCL, IOG and OAC occur in the subchondral bone close to the adjacent joint, whereas UCB occur in the metaphysis of long bones. Their aetiology and pathogenesis is still unknown, although primary damage to the subchondral bone, cartilage or local blood supply and growth disturbances are discussed. In this review 703 lesions of SCL in horses, 289 lesions of IOG and 1460 lesions of UCB in humans were compared in their anatomical location and clinical signs. SCL and OAC resembled each other with respect to anatomical location. A correlation of affected bones could not be found for all four groups. Clinical presentation concerning age was most similar for SCL and UCB with both lesions mainly occurring in young individuals. Gender predominance of males was present in SCL, IOG and UCB. Clinical diagnosis was either incidental, or connected with intermittent pain in all lesions except for OAC. Additionally, the lesions were also found in conjunction with degenerative joint disease (SCL, OAC) or pathological fractures (UCB). Cystic bone lesions were either treated conservatively, surgically with curettage alone, curettage in combination with grafting procedures, or intra-lesional application of corticosteroids. SCL and UCB were similar in their biological behaviour concerning their slow response to the therapy and relatively high recurrence rate. None of the cystic bone lesions were comparable, and a common aetiology and pathogenesis could not be found.In a literature review cases of cystic bone lesions in horses and humans were compared with the goal to find a common aetiology and pathogenesis. Cystic bone lesions occur in horses as subchondral cystic lesions (SCL), and in humans as either intra-osseous ganglia (IOG), subchondral cystic lesions secondary to osteoarthrosis (OAC) or unicameral bone cysts (UCB). IOG and OAC compare with SCL mainly in the anatomical location. IOG and SCL resemble each other in size, clinical signs and histology, whereas UCB and SCL show a similar biological behaviour regarding their therapeutic response and recurrence rate. None of the cystic bone lesions in humans were comparable to the SCL in horses in all aspects. A common aetiology and pathogenesis could not be established.

Download Full-text