Dermoid cyst differential diagnosis: Difference between revisions
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Krukenberg tumor]]<br><ref name="pmid8626898">{{cite journal |vauthors=Kim SH, Kim WH, Park KJ, Lee JK, Kim JS |title=CT and MR findings of Krukenberg tumors: comparison with primary ovarian tumors |journal=J Comput Assist Tomogr |volume=20 |issue=3 |pages=393–8 |date=1996 |pmid=8626898 |doi= |url=}}</ref><ref name="pmid17076540">{{cite journal |vauthors=Al-Agha OM, Nicastri AD |title=An in-depth look at Krukenberg tumor: an overview |journal=Arch. Pathol. Lab. Med. |volume=130 |issue=11 |pages=1725–30 |date=November 2006 |pmid=17076540 |doi=10.1043/1543-2165(2006)130[1725:AILAKT]2.0.CO;2 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Krukenberg tumor]]<br><ref name="pmid8626898">{{cite journal |vauthors=Kim SH, Kim WH, Park KJ, Lee JK, Kim JS |title=CT and MR findings of Krukenberg tumors: comparison with primary ovarian tumors |journal=J Comput Assist Tomogr |volume=20 |issue=3 |pages=393–8 |date=1996 |pmid=8626898 |doi= |url=}}</ref><ref name="pmid17076540">{{cite journal |vauthors=Al-Agha OM, Nicastri AD |title=An in-depth look at Krukenberg tumor: an overview |journal=Arch. Pathol. Lab. Med. |volume=130 |issue=11 |pages=1725–30 |date=November 2006 |pmid=17076540 |doi=10.1043/1543-2165(2006)130[1725:AILAKT]2.0.CO;2 |url=}}</ref> | ||
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* >55 y/o | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/– | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |– | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/– | |||
Based on underlying [[malignancy]] | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |– | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |– | |||
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* In case of [[Metastasis|metastatic]] [[Gastrointestinal cancer|GI cancers]] we may see [[iron deficiency anemia]] (IDA) | |||
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* Mostly bilateral, complex ovarian [[lesion]] | |||
* In [[CT scan]] we may see evidence of concurrent [[malignancy]] in other [[organs]] | |||
| style="background: #F5F5F5; padding: 5px;" | | |||
* Mostly bilateral, complex [[Ovary|ovarian]] [[lesion]] with solid components | |||
* Internal hyperintensity on T1 and T2 weighted [[Mri|MR]] [[images]] because of [[Mucin 17|mucin]] | |||
* Evidence of concurrent [[malignancy]] in other [[organs]] | |||
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*[[Mucin]]-secreting [[signet cell]] | |||
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*[[Imaging]]/<br>[[biopsy]] | |||
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* The most common [[primary tumor]] is in [[Colon (anatomy)|colon]], [[stomach]], [[breast]], [[lung]], and contralateral [[ovary]] | |||
* Based on underlying [[malignancy]] it may cause [[pleural effusion]] | |||
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| rowspan="5" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fallopian tube|Tubal]] | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[tubo-ovarian abscess]]<br><ref name="LandersSweet1983">{{cite journal|last1=Landers|first1=D. V.|last2=Sweet|first2=R. L.|title=Tubo-ovarian Abscess: Contemporary Approach to Management|journal=Clinical Infectious Diseases|volume=5|issue=5|year=1983|pages=876–884|issn=1058-4838|doi=10.1093/clinids/5.5.876}}</ref><ref name="Stewart TaylorMcMillan1975">{{cite journal|last1=Stewart Taylor|first1=E.|last2=McMillan|first2=James H.|last3=Greer|first3=Benjamin E.|last4=Droegemueller|first4=William|last5=Thompson|first5=Horace E.|title=The intrauterine device and tubo-ovarian abscess|journal=American Journal of Obstetrics and Gynecology|volume=123|issue=4|year=1975|pages=338–348|issn=00029378|doi=10.1016/S0002-9378(16)33434-2}}</ref><ref name="HaLim1995">{{cite journal|last1=Ha|first1=H. K.|last2=Lim|first2=G. Y.|last3=Cha|first3=E. S.|last4=Lee|first4=H. G.|last5=Ro|first5=H. J.|last6=Kim|first6=H. S.|last7=Kim|first7=H. H.|last8=Joo|first8=S. W.|last9=Jee|first9=M. K.|title=MR Imaging of Tubo-Ovarian Abscess|journal=Acta Radiologica|volume=36|issue=5|year=1995|pages=510–514|issn=0284-1851|doi=10.1080/02841859509173418}}</ref><ref name="pmid12854857">{{cite journal |vauthors=Varras M, Polyzos D, Perouli E, Noti P, Pantazis I, Akrivis Ch |title=Tubo-ovarian abscesses: spectrum of sonographic findings with surgical and pathological correlations |journal=Clin Exp Obstet Gynecol |volume=30 |issue=2-3 |pages=117–21 |date=2003 |pmid=12854857 |doi= |url=}}</ref> | |||
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* Young [[women]] (15-30 y/o | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |– | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | |||
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* High levels of [[Inflammation|inflammatory]] [[Marker|markers]] | |||
*[[Leukocytosis]] | |||
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* In [[Ultrasound|US]] we may see multilocular complex [[lesion]] mostly [[bilateral]] with debry inside | |||
| style="background: #F5F5F5; padding: 5px;" | | |||
* We may see a [[Pelvic masses|pelvic mass]] filled with [[fluid]] with thick walls | |||
* hypointense in T1 and heterogeneous in T2 | |||
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* In [[abscess]] [[aspiration]] we may see [[Anaerobic organism|anaerobic organisms]] | |||
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*[[History and Physical examination|History]]/<br>[[imaging]] | |||
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*The most common [[Risk factor|risk factors]] are previous [[PID]], [[diabetes mellitus]], [[intrauterine device]] and [[History and Physical examination|history]] of [[Uterus|uterine]] [[surgery]] | |||
===Spinal Dermoid Cysts=== | ===Spinal Dermoid Cysts=== |
Revision as of 17:23, 8 October 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]
Overview
Dermoid cyst must be differentiated from teratoma, as well as other common benign tumors that develop in the head and neck, ovaries, or spine (such as pilar cysts, steatocystoma, pilomatrixoma, encephalocele, vascular malformations, lipoleiomyoma, pilonidal cyst, and lipoma).[1][2][3][3][4]
Differential Diagnosis
Head and Neck
Dermoid cysts of head and neck must be differentiated from the following:[1][2]
- Pilar cysts (trichilemmal cyst)
- Acquired
- Intradermal
- Scalp is the most common site
- Steatocystoma multiplex
- Pilomatrixoma
- Encephalocele (when dermoid cysts appear on the medial aspect of the orbit)
- Ranula
- Vascular leiomyoma of the extracranial scalp
Ovarian Dermoid Cysts
- Ovarian dermoid cysts must be differentiated from the following:
- Haemorrhagic ovarian cyst
- Pedunculated lipoleiomyoma of the uterus
- Ovarian serous or mucinous cystadenoma/cystadenocarcinoma
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Age of onset | Symptoms | Physical examination | |||||||||||
Lab Findings | Imaging | Immunohistopathology | |||||||||||
Pelvic/abdominal pain or pressure | Vaginal bleeding/discharge | GI dysturbance | Fever | Tenderness | CT scan/US | MRI | |||||||
Gynecologic | |||||||||||||
Ovarian | Follicular cysts [5] |
|
+/– | – | – | – | +/– |
|
|
| |||
Theca lutein cysts [6][7][8] |
|
+/– | – | – | – | +/– |
|
|
|
| |||
Serous cystadenoma/carcinoma [9][10][11][12] |
|
+/– | – | – | – | +/– |
|
|
| ||||
Mucinous cystadenoma/carcinoma [13][14][15] |
|
+/– | – | – | – | +/– |
|
|
|
| |||
Endometrioma [16][17][18] |
|
+ | + | +/– | – | + |
|
|
|
| |||
Teratoma [19][20][21][22] |
|
+/– | – | – | – | +/– |
|
|
| ||||
Dysgerminoma [23][24] |
|
+ | +/– | – | – | +/– |
|
|
|
||||
Yolk sac tumor [25][26][27] |
+ | – | – | – | + |
|
|
|
|
| |||
Fibroma [28][29][30] |
|
|
– | – | – | +/– |
|
|
|
| |||
Thecoma [31][32][33] |
|
+/– | – | – | – |
|
|
|
|
| |||
Granulosa cell tumor [34][35][36][37] |
|
+ | +/– | – | – |
|
| ||||||
Sertoli-leydig cell tumor [38][39] |
|
+/– | – | – | – | – |
|
|
|
| |||
Brenner tumor [40][41] |
|
+/– | – | – | – | – | – |
|
|
|
| ||
Krukenberg tumor [42][43] |
|
+/– | – | +/–
Based on underlying malignancy |
– | – |
|
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|
| |||
Tubal | tubo-ovarian abscess [44][45][46][47] |
|
+ | + | – | + | + |
|
|
|
Spinal Dermoid Cysts
OthersDermoid cysts must also be differentiated from the following:[48]
References
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