PMC7749934_01
Preoperative images of the recurrent dermoid cyst (a). Note the subcutaneous swelling in the superolateral orbital area (white arrow) Fluid attenuated inversion recovery MR imaging (coronal) showed a well-circumscribed extracranial tumor component of 22 mm in diameter (b). CT (coronal) showed a tract traversing through the sphenoid bone (c).
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F1
A 43-year-old female presented with recurrent subcutaneous mass in the left superolateral orbital region [Figure 1a]. CT and MR imaging showed a subcutaneous mass with possible continuity to the Sylvian cistern by a tract in the sphenoid ridge and lesser wing of the sphenoid bone [Figure 1b and c].
Intraoperative findings. Part of the tract was inadvertently damaged and greasy and whitish yellow tumor content spilled out (a). The bone around the tumor tract was drilled and the tract was dissected (b), which ended in pouch at the surface of the dura (c).
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F2
When musculocutaneous flap was retracted, the cyst duct was inadvertently damaged, resulting in spill out of greasy and whitish yellow cyst content [Figure 2a]. We thus cut the cyst duct and followed the duct toward the bone [Figure 2b] and to the dura. The duct looked ending in a blind pouch at the surface of the dura [Figure 2c] near the lesser wing of the sphenoid bone.
A cystic lesion lined by an epidermal-like squamous epithelium contained several sebaceous glands, some of which continuous to the epithelium (a). A ductal structure, traversing through the sphenoid bone, was lined by a thin squamous epithelium with seldom keratinization (b). H&E: Hematoxylin and eosin; Original magnification x40.
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F3
It contained adnexa of skin, such as sebaceous glands and sweat glands [Figure 3].