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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

• Encephalocele – can also be found in the glabella area where dermoid cysts can be found; typically transilluminate, compressible / soft, and bluish in color
• Nasal glioma – can also be found in the glabella area; typically a firm nodule that is uncompressible and red
• Epidermal inclusion cyst / epidermoid cyst – dermoid cysts lack the overlying punctum seen in epidermoid cysts but may have an ostium
• Pilar cyst are firm and well circumscribed on palpation
• Pilomatricoma
• Nasolacrimal cyst
• Infantile hemangioma – compressible, red / purple, and follows typical growth pattern
• Hemangiopericytoma – typically inside the brain, but occasionally found on the head / neck, extremities, pelvic area
• Neurofibroma
• Melanotic neuroectodermal tumor of infancy
• Mesenchymal hamartomas (eg, lipoma, chondromesenchymal hamartoma)
• Teratoma
• Deep vascular lesion
• Sarcoma (rhabdomyosarcoma, fibrosarcoma, osteosarcoma) and neuroblastoma can present during infancy in rare cases

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References

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