Management of Perineal Epidermoid Cyst in a 20-year-old Female

Fatma Başak Tanoğlu, Çağlar Çetin, Osman Şevket, Gürkan Kıran, Burcu Gül
In: Düzce Tıp Fakültesi Dergisi · 2023 · vol. 25(2) , pp. 206–208 · doi:10.18678/dtfd.1284850 · W4385840592
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A 20-year-old female with severe pain and postmenstrual bleeding was diagnosed with a perineal epidermoid cyst mimicking endometriosis, highlighting the importance of accurate imaging to distinguish this benign lesion from endometriosis.

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This case report describes the clinical presentation and surgical management of a perineal epidermoid cyst in a 20-year-old female patient. The authors detail the diagnostic process, which involved identifying the lesion through physical examination and imaging, followed by complete excision to prevent recurrence or infection. Histopathological analysis confirmed the diagnosis as a benign epidermal inclusion cyst, highlighting the importance of accurate differential diagnosis for perineal masses. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Epidermoid cysts are cutaneous or subcutaneous masses caused by the implantation of epidermal elements into the dermis. This case report presented an epidermal cyst of the perineum clinically mimicking endometriosis in a female patient. A 20-year-old virgo female patient was admitted to our clinic with complaints of severe pain, especially in the right leg, and postmenstrual bleeding for three years. In the transrectal ultrasound, a 54*39 mm cystic lesion with dense internal echo was detected in the medial neighborhood of the pelvic floor right obturator internus muscle. Since the cystic lesion detected in the contrast-enhanced pelvic MRI was evaluated as an epidermoid cyst and no significant endometrioma or endometriosis focus was detected, an operation was planned. Surgical excision should be performed not only for symptom relief and diagnosis but also to exclude rare malignancy. However, it is vital to master the pelvic and perineal anatomy along with careful surgery.
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- Nigam JS, Bharti JN, Nair V, Gargade CB, Deshpande AH, Dey B, et al. Epidermal cysts: A clinicopathological analysis with emphasis on unusual findings. Int J Trichology. 2017;9(3):108-12. - Kirkham N. Tumors and cysts of the epidermis. In: Elder DE, editor. Lever's histopathology of the skin. 8th ed. Philadelphia: Lippincott-Raven; 1997. p.685-746. - Ali SA, Tahir SM, Memon AS, Dahri AA. Epidermoid inclusion cyst of the perineum--a rare case report in a 50 years old male. J Ayub Med Coll Abbottabad. 2009;21(3):179-80. - Dahan H, Arrivé L, Wendum D, Docou le Pointe H, Djouhri H, Tubiana JM. Retrorectal developmental cysts in adults: clinical and radiologic-histopathologic review, differential diagnosis and treatment. Radiographics. 2001;21(3):575-84. - Briggs RM, Miller FW. Pigmented nevi and epidermal cysts: cause and effect. Plast Reconstr Surg. 1968;41(5):456-61. - Morgan MB, Stevens GL, Somach S, Tannenbaum M. Carcinoma arising in epidermoid cyst: a case series and aetiological investigation of human papillomavirus. Br J Dermatol. 2001;145(3):505-6. - Sakurai T, Mukai T, Kawachi H, Hiyoshi Y, Yamaguchi T, Nagasaki T, et al. Laparoscopic resection for a relapsed presacral epidermoid cyst penetrating the ischiorectal fossa. Asian J Endosc Surg. 2022;15(3):656-9. - Sumi Y, Yamamoto N, Kiyosawa T. Squamous cell carcinoma arising in a giant epidermal cyst of the perineum: a case report and literature review. J Plast Surg Hand Surg. 2012;46(3-4):209-11. Details Primary Language English Subjects Clinical Sciences Journal Section Case Report Authors Caglar Cetin 0000-0001-6733-592X Türkiye Osman Şevket 0000-0003-4118-876X Türkiye Gürkan Kıran 0000-0002-6300-328X Türkiye Burcu Gül 0000-0003-3705-2464 Türkiye Early Pub Date August 15, 2023 Publication Date August 30, 2023 Submission Date April 18, 2023 Acceptance Date August 2, 2023 Published in Issue Year 2023 Volume: 25 Number: 2

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