Cases reported "Dermoid Cyst"

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11/113. Unusual imaging appearance of an intracranial dermoid cyst.

    Intracranial dermoid cysts have characteristic CT and MR imaging findings that generally make preoperative diagnosis straightforward. Enhancement of uncomplicated intradural dermoid cysts on CT or MR studies has been reported but is rare. We present a case of a posterior fossa dermoid cyst that was not only hyperattenuating on CT scans but also contained a mural nodule with clear evidence of enhancement on MR images.
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ranking = 1
keywords = operative
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12/113. Large cholesterol granuloma of the petrous apex treated via subcochlear drainage.

    This is a case report of a patient with bilateral cholesterol granuloma of the petrous apex, who presented with unilateral symptoms. Initially suspected as having a dermoid cyst, he underwent posterior fossa exploration, drainage and biopsy. Symptoms recurred one year later and subcochlear drainage of the petrous apex cyst was successfully performed. Follow-up for over 18 months shows no clinical nor imaging signs of recurrence. A medline literature search was carried out and relevant paper publications reviewed. Case presentation including initial, pre- and post-operative imaging is presented. This is followed by discussion of current concepts on the presentation and management of large cholesterol cysts of the petrous apex.
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13/113. Imaging and surgical approach of nasal dermoids.

    OBJECTIVE: Determine the most accurate and cost effective radiographic evaluation for nasal dermoids. Determine the best surgical approach for excision of nasal dermoids. DESIGN: Retrospective chart review. SETTING: Division of Pediatric otolaryngology, Children's Hospital and health Center, San Diego, california. PARTICIPANTS: All patients with nasal dermoids evaluated and treated from 1990 to 2000. INTERVENTION: Preoperative radiographic evaluation and surgical excision. OUTCOME MEASURES: Accuracy of CT and MRI correlated with surgical findings and results. RESULTS: Ten patients were identified with the diagnosis of nasal dermoid. The age at diagnosis ranged from 0 to 24 months, with a mean of 3 months. Six children presented with masses located at the glabella, three patients presented with masses located at the nasal dorsum and one presented with a mass at the nasal tip. Six children underwent a computed tomogram with contrast of the head. Seven children underwent a MRI study of the head. Three children underwent an initial CT followed by MRI. Twenty percent of children were found to have intracranial extension. CT scan accurately diagnosed intracranial extension in one case, was indeterminate in a second case and falsely positive in a third case. MRI correctly diagnosed intracranial extension in two cases and had no false positive or false negative results. No children were found to have associated intracranial anomalies. In the early years of the review, a simple excision was made over the mass with blunt and sharp dissection for removal. (An external rhinoplasty incision is now used with better exposure and improved cosmetic results.) In cases with intracranial communication, a combined approach of external rhinoplasty and craniotomy was used. CONCLUSIONS: MRI alone is the most cost effective and accurate means of evaluating nasal dermoids and is essential for preoperative planning. The surgical approach of choice is external rhinoplasty for both cosmetic reasons and exposure of nasal dermoids with and without intracranial extension.
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ranking = 2
keywords = operative
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14/113. Far-lateral approach to intradural lesions of the foramen magnum without resection of the occipital condyle.

    OBJECT: The goal of this study was to determine whether drilling out the occipital condyle facilitates surgery via the far-lateral approach by comparing data from 10 clinical cases with that from studies of eight cadaver heads. methods: During the last 6 years at louisiana State University health Sciences Center-Shreveport, 10 patients underwent surgery via the far-lateral approach to the foramen magnum. Six of these patients harbored anterior foramen magnum meningiomas, one patient a dermoid cyst, two patients vertebral artery (VA) aneurysms, and an additional patient suffered from rheumatoid disease of the craniocervical junction. The surgical approach consisted of retromastoid craniectomy and C-1 laminectomy. The seven tumors and the pannus of rheumatoid disease were completely excised, and the two aneurysms were clipped without drilling the occipital condyle. In one patient a chronic subdural hematoma was found 3 months after surgery, but no patient displayed any complication associated with surgery. It is significant that in no patient was a cerebrospinal fluid leak present. All patients experienced improved neurological function postoperatively. To compare surgical visibility, eight cadaveric specimens (16 sides) were studied, including delineation of the VA and its segments around the craniocervical junction. Increase in visibility as a function of fractional removal of the occipital condyle was quantified by measuring the degrees of visibility gained by removing one third and one half of the occipital condyle. Removal of one third of the occipital condyle produced a mean increase of 15.9 degrees visibility, and removal of one half produced a mean increase of 19.9 degrees. CONCLUSIONS: On the basis of their findings the authors conclude that removal of the occipital condyle is not necessary for the safe and complete resection of anterior intradural foramen magnum tumors.
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ranking = 1
keywords = operative
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15/113. Correction of bone deformity after resection of dermoid cyst using artificial dermis implantation.

    We report cases of the dermoid cyst patients with a bone deformity that were treated with artificial dermis implantation. After resecting the tumor, three or five sheets of artificial dermis (Terudermis, Terumo Co. Ltd, tokyo, japan) are placed into the depressed site in order to create symmetrical surface with the contralateral side. Neither of the cases presented here showed allergic or infectious reaction during postoperative follow-up period. In both cases, the texture of the implanted region is almost the same as the contralateral side and is almost symmetrical. We believe that artificial dermis may be a useful implantation material to correct depressions in the patient with dermoid cysts.
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keywords = operative
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16/113. Intraperitoneal cancer spread after laparoscopic cystectomy for mature teratoma with malignant transformation.

    Laparoscopic surgery for ovarian dermoid cysts has been accepted. However, its potential limitations should be considered, including technique difficulty, intraoperative tumor spillage and malignant transformation. We report a case of ovarian dermoid cysts with malignant transformation that was initially treated using laparoscopic cystectomy, but was complicated by intraperitoneal tumor dissemination.
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ranking = 1
keywords = operative
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17/113. Three-dimensional computed tomography of congenital nasal anomalies.

    OBJECTIVE: To determine the utility of performing three-dimensional (3D) computed tomography (CT) of congenital naso-frontal anomalies for preoperative planning and counseling and compare it with standard two-dimensional (2D) imaging and intraoperative findings. STUDY DESIGN: Prospective case evaluation of imaging studies and medical records in cohort of patients with congenital nasal anomalies. methods: We performed 3D CT imaging of three different types of congenital nasal lesions. Additional preoperative imaging consisted of standard 2D CT scans and/or magnetic resonance imaging (MRI). Information obtained from the 3D CTs was compared with other standard imaging and intraoperative findings. RESULTS: 3D CT was most useful in the case of a large encephalocele with a significant bony defect of the anterior cranial fossa. It provided moderate utility when used to evaluate a nasal dermoid with nasal bone and septal abnormalities and was of limited benefit in the case of a bifid nose with significant external soft tissue deformity and relatively normal bony anatomy. CONCLUSION: Congenital midline nasal anomalies are rare lesions with the potential for intracranial extension and anterior skull base abnormalities. The safe surgical treatment of these lesions depends upon accurate preoperative imaging to assist in establishing the diagnosis, to help guide surgical planning, and to assist in communicating the diagnosis and surgical approach for optimal counseling of families. 3D CT was instrumental in providing additional useful information in cases with significant bony abnormalities at little additional cost or time. It is also beneficial for preoperative counseling of patients and families with limited medical knowledge.
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ranking = 6
keywords = operative
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18/113. Reversible holocord edema associated with intramedullary spinal abscess secondary to an infected dermoid cyst.

    We report a case of a holocord high-intensity lesion extending from L1 up to the medulla oblongata on T2-weighted spinal magnetic resonance imaging (MRI) associated with an intramedullary spinal abscess secondary to an infected dermoid cyst. The intraoperative findings revealed that the high-intensity lesion on the T2-weighted image was edematous tissue. The MRI change in the spinal cord gradually improved in response to the use of postoperative antibiotics. The change was considered to represent reversible inflammatory changes, as there was no neurological deficit found at the cervical level and it resolved after surgery and medical treatment. The pathomechanism is discussed herein.
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ranking = 2
keywords = operative
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19/113. A case of large dermoid cyst in the floor of the mouth.

    Dermoid cysts in the floor of the mouth are rarely observed. When they develop, they do not appear until they grow large enough or appear through infection. Some operative approaches and management have been performed to large dermoid cysts in the floor of the mouth with some variations. Intra-oral approach is the most useful for cosmetic appearance. We presented a 24-year-old female who underwent expedient surgical excision using finger end serviceable enucleation through the intra-oral approach.
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ranking = 1
keywords = operative
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20/113. Chemical peritonitis: a rare complication of an iatrogenic ovarian dermoid cyst rupture.

    laparoscopy is the standard method for the diagnosis and treatment of ovarian dermoid cysts, which represent 10% to 15% of all ovarian tumors. This procedure offers many advantages including less postoperative pain, lower risk of wound complication, early ambulation, and more rapid convalescence. The risk of adhesion formation also is reduced. However, in the case of an ovarian dermoid cyst, the laparoscopic approach could result in chemical peritonitis caused by the spilled contents of a ruptured dermoid cyst. We report a case of chemical peritonitis after rupture of an ovarian dermoid cyst during laparoscopy. Two operations were required, and medical treatment was not beneficial. We discuss a possible new medication for the treatment of this complication and compare this case with other recent reports.
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ranking = 1
keywords = operative
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