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Middle Mediastinal Bronchogenic Cyst
Joseph Junewick, MD FACR
over 5 years ago
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Dermoid

Case Detail

Anatomy: Brain-Spine
Borders
Heather Borders, MD
Diagnostic Category: Developmental or Congenital
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: CT MRI
Activities:
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History

12 year old with midline scalp mass that has recently grown.


Case Images


Diagnosis

Dermoid

Findings

Large smooth walled hypodense cyst with scalloping and remodelling of adjacent bones on CT. Mildly complicated cyst characteristics on MRI without enhancement and no intracranial involvement. No restricted diffusion.

Discussion

A mass located near the anterior fontanelle is most commonly a dermoid. Dermoid and epidermoid inclusion cysts occur in the midline or paramidline due to faulty closure of the neural groove. Dermoids comprise approximately 20% of scalp lesions. These most commonly present in the first few months of life with a soft or firm midline mass.

Dermoid cyst is a pathologic term for a cyst lined by squamous epithelium containing skin appendages (hair follicles, sebaceous, and sweat glands).

Imaging characteristics are variable reflecting the above described pathology. CT usually shows a well defined mildly heterogeneous hypodense mass that is round and causes scalloping of the adjacent bone. MRI usually shows a well defined mass that is isointense to immature brain or isointense to CSF on T1 and hyperintense on T2. There is not restricted diffusion as can be seen with epidermoids. The separation from underlying brain should be easily identified. US will show a smooth walled cyst.

Reference

Barkovich; Pediatric neuroimaging.
Indian J Plast Surg. 2008 Jul–Dec; 41(2): 238–240.



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