RESUMO
Introducción: Durante el desarrollo embriológico, el espacio retrorrectal o presacro está ocupado por células pluripotenciales y, por tanto, puede contener un grupo heterogéneo de tumores. El quiste dermoide es una entidad muy rara dentro de este grupo de tumores. Descripción de caso: femenina de 36 años de edad, con sensación de pesadez en hipogastrio, dolor en sedestación, y cambios en patrón evacuatorio; se realizó palpación abdominal, tacto rectal positivo para masa blanda dolorosa; eco endoanal y resonancia evidenciaron lesión ocupante de espacio presacro. Se realizó exéresis completa vía abdominal, con diagnóstico histopatológico definitivo de quiste dermoide. Discusión: un tumor presacro involucra un reto diagnóstico y terapéutico debido a la gran variedad de diagnósticos diferenciales. En el presente caso se diagnosticó un quiste dermoide, tumor benigno, fuera de su localización habitual. Conclusión: los tumores retrorrectales son lesiones poco habituales, es necesaria la exéresis completa y su posterior estudio histopatológico, para establecer su naturaleza. (AU)
Introduction: During embryological development, the retrorectal or presacral space is occupiedby pluripotent cells and, therefore, may contain a heterogeneous group of tumors. The dermoid cyst is a very rare entity within this group of tumors. Materials and methods: We present a case of a 36-year-old female patient with a sensation of heaviness inthe hypogastrium. Magnetic resonance imaging was performed in which presacral tumor was evident. Results: complete abdominal excision was performed, with a definitive histopathological diagnosis of dermoid cyst. Discussion: a presacral tumor involves a diagnostic and therapeutic challenge due to the great variety of differential diagnoses. The present case was diagnosed with a dermoid cyst, a benign tumor, outside its usual location. Conclusion: Retrorectal tumors are rare tumors, in which complete excision and histopathological report are necessary. (AU)
Assuntos
Humanos , Feminino , Adulto , Cisto Dermoide/diagnóstico , Canal Anal , Reto/patologia , Sacro/patologia , Biópsia , Tomografia Computadorizada de EmissãoRESUMO
Dermoid cysts (DCs) and epidermoid cysts (ECs) are uncommon developmental cysts affecting the oral cavity. This study aims to evaluate patients with oral DCs and ECs and their demographic and clinicopathologic features. A retrospective descriptive cross-sectional study was performed. A total of 105,077 biopsy records of oral and maxillofacial lesions from seven Brazilian oral pathology centers were analyzed. All cases diagnosed as oral DCs and ECs were reviewed, and clinical, demographic, and histopathological data were collected. The series comprised 32 DCs (31.4%) and 70 ECs (68.6%). Most of the DCs occurred on the floor of the mouth (n = 14; 45.2%) of women (n = 17; 53.1%) with a mean age of 34.6 ± 21.6 years. All DCs were lined partially or entirely by stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were observed in the fibrous capsule . Most of the ECs affected the labial mucosa (n = 20; 31.7%) of men (n = 39; 56.5%) with a mean age of 48.0±19.8 years. Microscopically, most ECs (n = 68; 97.1%) were lined entirely by stratified squamous epithelium. Two cysts (2.9%) showed areas of respiratory metaplasia. Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were also observed in the fibrous capsule. Conservative surgical excision was the treatment of choice in all cases. Oral DCs and ECs are uncommon and often clinically misdiagnosed lesions. Clinicians should consider DCs and ECs in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located on the floor of the mouth and labial mucosa.
Assuntos
Cisto Dermoide , Cisto Epidérmico , Neoplasias Bucais , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Brasil/epidemiologia , Colesterol , Estudos Transversais , Cisto Dermoide/epidemiologia , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Cisto Epidérmico/epidemiologia , Cisto Epidérmico/patologia , Cisto Epidérmico/cirurgia , Melaninas , Estudos Retrospectivos , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgiaRESUMO
O cisto epidermóide (CE) é uma má formação cística de desenvolvimento incomum. Ocorre mais comumente na linha média do assoalho da boca, ocasionalmente localiza-se lateralmente ou em outros sítios. A etiologia do CE ainda é incerta, mas acredita-se que esteja associado a remanentes do ectoderma durante a fusão do primeiro e segundo arcos branquiais. A lesão cresce lentamente sem provocar dor, apresentando-se como massa de consistência semelhante à de borracha ou à massa de pão. Seu diagnóstico se dá por meio de exame clínico e exames complementares de imagem como tomografia computadorizada, ressonância magnética e/ou ultrassonografia, entretanto somente com o exame histopatológico é possível um diagnóstico definitivo. A excisão cirúrgica do cisto é o tratamento de escolha. Quando o diagnóstico é precoce e a intervenção correta, o índice de recidiva torna-se raro. Diante da raridade de casos na região maxilo facial e a dificuldade relacionada ao diagnóstico, o presente trabalho tem como objetivos descrever a ocorrência do cisto epidermóide bem como seu diagnóstico através de exame histopatológico/exames de imagem, tratamento cirúrgico e contribuir com a literatura já existente por meio de um relato de caso que foi diagnosticado no Serviço de Patologia Bucal da Universidade de Gurupi, campus Gurupi/TO.
Epidermoid cysts (EC) is an unusually developing cystic malformation that occurs most frequently in the midline of the floor of the mouth, occasionally located laterally or elsewhere. The etiology of the (EC) still uncertain, but it is believed to be associated with remnants of the ectoderm during the fusion of the first and second branchial arches. The lesion grows slowly without causing pain, presenting itself as a mass with a consistency like of rubber or bread dough. Diagnosis of (EC) is made through complementary imaging tests such as computed tomography, magnetic resonance imaging and/or ultrasound, only histopathological examination it is possible to obtain a definitive diagnosis. Surgical excision of cyst is the treatment of choice. When the diagnosis is made early and the intervention is correct, the recurrence rate is rare. Given the rarity of cases in the maxillofacial region and the difficulty related to diagnosis, this study aims to describe epidermoid cysts occurrence and your diagnostic through of histopathologic/imagine exams, surgical treatment and contribute to the existing literature, through a review and description of a clinical case that was diagnosed at the Oral Pathology Outpatient Clinic at the Faculty of Dentistry - University of Gurupi - UNIRG. Gurupi -Tocantins. Brazil.
El quiste epidermoide (CE) es una malformación quística de desarrollo infrecuente. Ocurre más comúnmente en la línea media del piso de la boca, ocasionalmente se localiza lateralmente o en otra parte. La etiología de la FB aún es incierta, pero se cree que está asociada con restos del ectodermo durante la fusión del primer y segundo arcos branquiales. La lesión crece lentamente sin causar dolor, apareciendo como una masa con una consistencia similar a la de la goma o la masa de pan. Su diagnóstico se realiza a través del examen clínico y pruebas de imagen complementarias como tomografía computarizada, resonancia magnética y/o ultrasonografía, sin embargo, solo con el examen histopatológico es posible un diagnóstico defi nitivo. La escisión quirúrgica del quiste es el tratamiento de elección. Cuando el diagnóstico es temprano y la intervención es correcta, la tasa de recurrencia se vuelve rara. Dada la rareza de los casos en la región maxilofacial y la difi cultad relacionada con el diagnóstico, el presente trabajo tiene como objetivo describir la ocurrencia del quiste epidermoide así como su diagnóstico a través del examen histopatológico/pruebas de imagen, tratamiento quirúrgico y contribuir a la literatura existente a través de un reporte de caso que fue diagnosticado en el Servicio de Patología Oral de la Universidad de Gurupi, campus Gurupi/TO.
Assuntos
Humanos , Masculino , Adulto , Cisto Dermoide , Neoplasias de Cabeça e Pescoço , Osso Hioide , Tomografia Computadorizada por Raios XRESUMO
Cistos dermoides são considerados uma má formação cística que apresentam comportamento benigno e são raros na região de cabeça e pescoço. São descritos como um cisto de desenvolvimento que contém anexos da derme como glândulas sudoríparas, glândulas sebáceas e folículos pilosos revestidos por epitélio escamoso estratificado. Ocorrem com maior frequência na linha média do assoalho da boca. O objetivo do estudo é descrever um caso clínico de paciente do sexo feminino portadora de cisto dermoide em assolho bucal, descrever os achados clínicos, imagiológicos, anatomopatológicas, bem como os tempos cirúrgicos da abordagem e apresentar a evolução pós operatória do caso. A paciente referiu aumento de volume em assoalho de boca, com piora progressiva. Relatou disfagia, dislalia, odinofagia e dispneia com evolução para desconforto respiratório e ronco ocasional. O tratamento foi realizado em procedimento cirúrgico com acesso intraoral seguido de exérese completa da lesão. O exame anatomopatológico revelou cavidade cística revestida por epitélio estratificado pavimentoso hiperortoceratinizado. Cápsula era constituída de tecido conjuntivo fibroso, vascularizado, com coleções de células inflamatórias mononucleares e presença de glândulas sebáceas e fibras musculares esqueléticas. Grande quantidade de ceratina no formato de filamentos, também observado no lúmen da lesão. O anatomopatológico confirmou o diagnóstico de cisto dermoide.
Dermoid cysts are considered a cystic malformation that show benign and rare in the head and neck region. They are described as a developmental cyst that contains appendages of the dermis such as sweat glands, sebaceous glands and hair follicles covered by stratified squamous epithelium. They occur more frequently in the midline of the floor of the mouth. The aim of the study is to describe a clinical case of a female patient with a dermoid cyst in oral cavity, describe the clinical, imaging, anatomopathological findings, as well as the surgical times of the approach and present the postoperative evolution of the case. The patient reported an increase in volume on the floor of the mouth, with progressive worsening. She reported dysphagia, dyslalia, odynophagia and dyspnea with progression to respiratory distress and snoring. The treatment was performed in a surgical procedure with intraoral approach followed by complete excision of the lesion. The histopathological examination revealed a cystic cavity covered by a stratified hyperortoceratinized stratified epithelium. Capsule consisted of fibrous, vascularized connective tissue, with collections of mononuclear inflammatory cells and the presence of sebaceous glands and skeletal muscle fibers. Large amount of keratin in the form of filaments, also observed in the lumen of the lesion. The histopathology diagnosis was dermoid cyst.
Assuntos
Cisto Dermoide , Boca , NeoplasiasRESUMO
BACKGROUND Dermoid cysts are rare benign intracranial tumors that usually present classic computed tomography (CT) and magnetic resonance imaging (MRI) characteristics, allowing for relatively simple diagnostic confirmation. Atypical imaging features can occur due to their diverse ectodermal-derived content, which can result in a diagnostic dilemma. Making an accurate diagnosis is essential for adequate management. CASE REPORT We present a case of a 39-year-old woman with past medical history of increased blood pressure, presenting with worsening headaches non-refractory to medication. Imaging revealed an extra-axial lesion within the midline posterior fossa with an occipital transdiploic linear channel. The lesion was T2 profoundly hypointense on brain MRI, and prominently hyperdense on non-contrast CT scan. Catheter angiography excluded vascular etiology. After complete lesion resection, results of the histopathologic examination were consistent with a dermoid cyst. Dermoid cysts that are hyperdense on CT and hypointense on T2-WI are extremely rare. CONCLUSIONS Complete surgical resection is the treatment of choice for most dermoid cysts. Atypical radiologic features, in an already rare intracranial tumor, can delay correct diagnosis and management. Recognition of these findings is therefore important for adequate imaging analysis of these lesions.