Hussam H Mady1, Mona F Melhem. 1. Department of Pathology, University of Pittsburgh Medical Center and the Veterans' Administration Healthcare System, Pittsburgh, PA 15240, USA.
Abstract
BACKGROUND: Pure, benign epidermoid cysts of the abdominal viscera are rare. There have been only four reports of epidermoid cysts of the cecum in the literature, two following appendectomies and attributed to the surgical procedure, and two in female patients, raising the possibility of dermoid cysts related to the ovaries. PATIENTS AND METHODS: We report the first case of epidermoid cyst of the cecum in an elderly man with no previous history of trauma or surgery, detected by computed tomography as an incidental finding of extraluminal cystic cecal mass. It was treated by partial colectomy. Pathologically the cyst was roughly spherical, extending from and expanding the serosal surface of the cecum with no communication through the muscularis wall. Histologically the inner lining of the cyst was composed of benign, mature, keratinized, stratified squamous epithelium with a well formed granular layer. No calcification, hair, teeth, or bone elements was detected. RESULTS: The interesting finding in our case is the unusual anatomical location and the age and sex of the patient. The patient had no history of any abdominal surgical procedures. The most likely explanation for the presence and development of an epidermoid cyst in this location is the result of an aberrant ectodermal implantation during embryogenesis. CONCLUSION: Awareness of the possibility of the presence of epidermoid cysts in this area with distinctive radiological findings consistent with a well circumscribed benign cyst should be considered in the differential diagnosis of cysts within the abdomen.
BACKGROUND: Pure, benign epidermoid cysts of the abdominal viscera are rare. There have been only four reports of epidermoid cysts of the cecum in the literature, two following appendectomies and attributed to the surgical procedure, and two in female patients, raising the possibility of dermoid cysts related to the ovaries. PATIENTS AND METHODS: We report the first case of epidermoid cyst of the cecum in an elderly man with no previous history of trauma or surgery, detected by computed tomography as an incidental finding of extraluminal cystic cecal mass. It was treated by partial colectomy. Pathologically the cyst was roughly spherical, extending from and expanding the serosal surface of the cecum with no communication through the muscularis wall. Histologically the inner lining of the cyst was composed of benign, mature, keratinized, stratified squamous epithelium with a well formed granular layer. No calcification, hair, teeth, or bone elements was detected. RESULTS: The interesting finding in our case is the unusual anatomical location and the age and sex of the patient. The patient had no history of any abdominal surgical procedures. The most likely explanation for the presence and development of an epidermoid cyst in this location is the result of an aberrant ectodermal implantation during embryogenesis. CONCLUSION: Awareness of the possibility of the presence of epidermoid cysts in this area with distinctive radiological findings consistent with a well circumscribed benign cyst should be considered in the differential diagnosis of cysts within the abdomen.