A cutaneous dermoid cyst results from an alteration in fetal development at the lines of cleavage and is postulated to result from entrapped ectodermal cells during embryonic development. The cyst contains a keratinizing epithelial lining, sebaceous glands, eccrine glands, and sometimes lanugo hair. Dermoid cysts may be cutaneous or deeper. Cutaneous dermoid cysts are typically seen at birth or noticed shortly thereafter. They are typically found on the head. They may have intracranial connections; thus, biopsy and removal should be done by an appropriate surgeon to avoid neurological complications, such as central nervous system (CNS) infection that could lead to frontal lobe abscess, meningoencephalitis, or seizures.
Non-cutaneous dermoid cysts can be found inside the skull, spine, and reproductive organs.
Cutaneous dermoid cyst in Adult
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Synopsis
Codes
ICD10CM:
D23.9 – Other benign neoplasm of skin, unspecified
SNOMEDCT:
201325006 – Dermoid cyst of skin
D23.9 – Other benign neoplasm of skin, unspecified
SNOMEDCT:
201325006 – Dermoid cyst of skin
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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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Last Reviewed:07/28/2021
Last Updated:08/05/2021
Last Updated:08/05/2021
Cutaneous dermoid cyst in Adult