A Rare Case of Multiple Epidermal Cyst Scrotum and Its Excision Under Spermatic Cord Block Obviating Spinal Or General Anaesthesia Need

Epidermal cysts are the most common epithelial cysts usually with non malignant potential. These occur commonly in hair- bearing areas mostly on the scalp, also on the face, neck, back, and scrotum. Etiology is usually unknown. It can be seen commonly in individuals with history of significant Acne vulgaris. Multiple sebaceous cysts over the scrotum is a rare condition. Only eight cases of multiple epidermal cysts in scrotum have been reported so far from India in the past literature. This condition is usually asymptomatic and painless. It may turn painful if gets infected and often may be associated with discharge of pus. We present a rare case of multiple epidermal cysts of scrotum in a 36 year old patient which was managed with complete excision of the cysts done under local anesthesia followed by primary closure with better outcome in cosmesis taking care of not to jeopardize the vascular supply to local flaps and testis.

A Case Report of Calyceal Diverticulum: Differential Diagnosis for Organ-Preserving Operations

Calyceal diverticula and epidermal cysts are extremely rare kidney lesions with unknown etiology and pathogenesis. They have non-specific clinical and radiological picture. Despite the benign nature, sometimes these disorders mimic malignant tumors leading to unjustified nephrectomy. We present a clinical and morphological observation of a multicystic lesion in a 76-year-old patient's right kidney filled with keratinized masses and imitating a malignant solid tumor. The detailed gross, histological and immunohistochemical (desmin, cytokeratin 7, uroplakin and p63) analyses of the kidney tissue excluded the malignant nature of the lesion. The final differential diagnosis was between an epidermal cyst and calyceal diverticulum with pronounced squamous cell metaplasia of urothelium. The upper pole localization of the lesion, its connection with the pelvicalyceal system through the unobstructed isthmus, the presence of urothelial lining and smooth muscle cells in its wall let us diagnose a calyceal diverticulum type I. Knowledge of the key clinical and morphological features of epidermal cysts and diverticula of the pelvicalyceal system will help the practicing physicians suspect the benign nature of such lesions and perform organ-preserving operations.

Dirofilariasis in humans presenting as a subcutaneous nodule

Human dirofilariasis is an uncommon zoonotic roundworm infection caused by worms belonging to dirofilaria species transmitted by zoo -anthropophilic blood sucking insects which is known to manifest as ocular infection or as a subcutaneous nodule usually in the upper part of the body. We present a case report of subcutaneous dirofilariasis in the left temporal region besides the eye brow in a 65yr old female, clinically diagnosed as epidermal cyst. Gross and histopathological evaluation revealed the presence of an adult worm with granulomatous inflammatory reaction.

Basal cell carcinoma developed from an epidermal cyst: A case report and review of the literature

Cutaneous epidermal cysts are common benign cysts derived from the epidermis or epithelium of hair follicles, and malignancy originating from epidermal cysts is uncommon. When a cutaneous epidermal cyst turns malignant, it is mostly squamous cell carcinoma, and basal cell carcinoma is rare. We present the case of a 58-year-old man with basal cell carcinoma originating from an epidermal cyst on the buttocks. Histopathological analysis with hematoxylin- eosin (H&E) staining showed the presence of the cyst, the wall of which was partially replaced by a malignant tumor. Moreover, the cyst was filled with malignant tumor cells in some areas. The tumor cells were basaloid, and extended through the dermis down to the subcutaneous tissue in a solid pattern. Immunoperoxidase staining for Ber-EP4 was positive. To our knowledge, there are 11 reported cases of BCC originating from epidermal cysts in English, and we reviewed these reports and examined potential trends. We estimate that some longstanding epidermal cysts may have the potential of malignant transformation, and chronic and repeated irritation might trigger malignancy from epidermal cysts. We emphasize that benignlooking cystic lesions showing progressive growth should be examined histopathologically.

A HISTOPATHOLOGICAL STUDY OF LIMB LESIONS: RETROSPECTIVE STUDY AT RIMS, RANCHI

Limb lesions of skin, soft tissue and bone are commonly encountered. They include a multitude of non neoplastic, benign and malignant diseases ranging from lipoma to brosarcoma and from epidermal cyst to squamous cell carcinoma. An insight of the pattern of various limb diseases in relation to site, age, and type of lesion assists in better comprehension of differential diagnosis for histopathologists. A retrospective study of histopathologically diagnosed cases of Material & Methods: 47 limb lesion patients from June 2020 to May 2021 was undertaken. A total 47 cases included 28 male and 19 female, Results: 55% of cases belong to age group 21 to 50 years. 13 (28%) cases were of upper extremity and 34 (72%) from lower extremity. 15 (34%) cases were non-neoplastic, 13 (28%) were benign lesion and rest 19 (38%) were malignant lesions. Lower limb lesions are more common than Conclusion: upper limb lesions. Squamous cell carcinoma is the most common malignant neoplasm and lipoma is the most common benign disease of extremity. Pyogenic granuloma and epidermal cyst were found to be the most common non-neoplastic extremity lesions. Fibrosarcoma was the most common type of sarcoma observed in 9% cases. Chronic osteomyelitis was the most common bony lesion.