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Infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess: A case report

INTRODUCTION: Infection is a rare complication of intradural dermoid cyst. We reported an infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess. PRESENTATION OF CASE: A 4-year-old boy with no medical history complained of a palpable mass on his head. On examination, the...

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Autores principales: Pham, Anh Hoang, Le, Tam Duc, Chu, Hung Thanh, Le, Tuan Anh, Duong, Ha Dai, Van Dong, He
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298525/
https://www.ncbi.nlm.nih.gov/pubmed/32535529
http://dx.doi.org/10.1016/j.ijscr.2020.05.052
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author Pham, Anh Hoang
Le, Tam Duc
Chu, Hung Thanh
Le, Tuan Anh
Duong, Ha Dai
Van Dong, He
author_facet Pham, Anh Hoang
Le, Tam Duc
Chu, Hung Thanh
Le, Tuan Anh
Duong, Ha Dai
Van Dong, He
author_sort Pham, Anh Hoang
collection PubMed
description INTRODUCTION: Infection is a rare complication of intradural dermoid cyst. We reported an infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess. PRESENTATION OF CASE: A 4-year-old boy with no medical history complained of a palpable mass on his head. On examination, the occipital palpable mass was firm and immobile, had no redness, swelling, and pain. The preoperative MRI showed a well-defined, ring-enhancing lesion. White blood count was [Formula: see text] cells/liter. We have sought no other infection sites. We encountered intraoperatively the pus from the infected mass invading subcutaneous layer and skull bone. We excised completely the tumor and carefully coagulated the residual capsule invading superior sagittal sinus. Histopathological examination was infected dermoid cyst. The infection agent was Staphylococcus aureus. The patient was received systemic antibiotic therapy for 21 days following oral antibiotics for 1 month. He was discharged with no complications. DISCUSSION: The diagnosis of infected dermoid cyst was often based on MRI images and especially dermal sinus tract. However, in the absence of a dermal sinus tract, preoperative diagnosing an infected dermoid cyst might be very challenging. The ideal treatment of the dermoid cyst was total resection of the cyst with the epithelial lining. Nevertheless, due to the benign nature of dermoid cyst, adequate gross total resection with meticulous hemostasis the residual capsule firmly adhering eloquent areas and major vessels was more appropriate. CONCLUSION: Diagnosing infected dermoid cyst with no dermal sinus might be challenging. Systemic antibiotic therapy after gross total resection was an effective treatment.
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spelling pubmed-72985252020-06-19 Infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess: A case report Pham, Anh Hoang Le, Tam Duc Chu, Hung Thanh Le, Tuan Anh Duong, Ha Dai Van Dong, He Int J Surg Case Rep Article INTRODUCTION: Infection is a rare complication of intradural dermoid cyst. We reported an infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess. PRESENTATION OF CASE: A 4-year-old boy with no medical history complained of a palpable mass on his head. On examination, the occipital palpable mass was firm and immobile, had no redness, swelling, and pain. The preoperative MRI showed a well-defined, ring-enhancing lesion. White blood count was [Formula: see text] cells/liter. We have sought no other infection sites. We encountered intraoperatively the pus from the infected mass invading subcutaneous layer and skull bone. We excised completely the tumor and carefully coagulated the residual capsule invading superior sagittal sinus. Histopathological examination was infected dermoid cyst. The infection agent was Staphylococcus aureus. The patient was received systemic antibiotic therapy for 21 days following oral antibiotics for 1 month. He was discharged with no complications. DISCUSSION: The diagnosis of infected dermoid cyst was often based on MRI images and especially dermal sinus tract. However, in the absence of a dermal sinus tract, preoperative diagnosing an infected dermoid cyst might be very challenging. The ideal treatment of the dermoid cyst was total resection of the cyst with the epithelial lining. Nevertheless, due to the benign nature of dermoid cyst, adequate gross total resection with meticulous hemostasis the residual capsule firmly adhering eloquent areas and major vessels was more appropriate. CONCLUSION: Diagnosing infected dermoid cyst with no dermal sinus might be challenging. Systemic antibiotic therapy after gross total resection was an effective treatment. Elsevier 2020-05-30 /pmc/articles/PMC7298525/ /pubmed/32535529 http://dx.doi.org/10.1016/j.ijscr.2020.05.052 Text en © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pham, Anh Hoang
Le, Tam Duc
Chu, Hung Thanh
Le, Tuan Anh
Duong, Ha Dai
Van Dong, He
Infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess: A case report
title Infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess: A case report
title_full Infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess: A case report
title_fullStr Infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess: A case report
title_full_unstemmed Infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess: A case report
title_short Infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess: A case report
title_sort infected intradural dermoid cyst without dermal sinus tract mimicking brain abscess: a case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298525/
https://www.ncbi.nlm.nih.gov/pubmed/32535529
http://dx.doi.org/10.1016/j.ijscr.2020.05.052
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