Dermoid cysts masquerading as pilonidal sinus disease
- Authors: Darya S.D.1, Barkhatov S.I.1, Safyanov L.A.1, Pikuza M.N.1, Kostin R.N.1, Tsarkov P.V.1
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Affiliations:
- I.M. Sechenov First Moscow State Medical University
- Issue: Vol 29, No 6 (2023)
- Pages: 511-520
- Section: Case reports
- URL: https://journals.rcsi.science/0869-2106/article/view/254738
- DOI: https://doi.org/10.17816/medjrf601836
- ID: 254738
Cite item
Abstract
BACKGROUND: Dermoid cysts (DC) are benign cystic tumors formed because of impaired embryogenesis processes when ectodermal rudiments are immersed in tissues and organs along the lines of their embryonic fusion. DC is most often localized in the head and neck (84%). Rarer localizations areas are as follows: 1) ovaries; 2) retroperitoneal space; 3) mediastinum; 4) pancreas and spleen; 5) spinal canal. In case of retroperitoneal localization of DC, the presacral location occurs more often, then location in soft tissues of the sacrococcygeal region. Moreover, the clinical pattern may be similar to that of pilonidal disease, which may cause difficulties in diagnosis at the preoperative diagnostics and further determination of the surgical techniques.
CLINICAL CASES DESCRIPTION: In the Clinic of colorectal and minimally invasive surgery, two clinical cases of dermoid cysts masquerading as pilonidal sinus disease were encountered. In both cases, Bascom II surgery was performed. Macroscopic examination of the specimens revealed pathognomonic signs of dermoid cysts: a hair growth site on the epithelial lining of the cyst in the first case and the presence of sebum in the cyst cavity in the second case. The early postoperative period in both patients proceeded smoothly, and no data were obtained for recurrence in the 6- and 18-month follow-up period.
CONCLUSION: Because of the similar clinical picture of pilonidal cysts and DC of the sacrococcygeal region, differential diagnosis is crucial. A wide range of minimally invasive methods are available for treating pilonidal disease; however, they are not appropriate for the treatment of DC. At present, the only radical method of treating DCs of the sacrococcygeal region is excision of the cyst without rupturing the capsule to prevent disease recurrence.
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##article.viewOnOriginalSite##About the authors
Shlyk D. Darya
I.M. Sechenov First Moscow State Medical University
Email: shlikdarya@gmail.com
ORCID iD: 0000-0002-9232-6520
SPIN-code: 4948-3550
MD, Cand. Sci. (Med.), associate professor
Russian Federation, 1/1 Pogodinskaya street, 119435, MoscowSergey I. Barkhatov
I.M. Sechenov First Moscow State Medical University
Email: barsiv@mail.ru
ORCID iD: 0000-0003-4702-5558
MD, Cand. Sci. (Med.), associate professor
Russian Federation, 1/1 Pogodinskaya street, 119435, MoscowLev A. Safyanov
I.M. Sechenov First Moscow State Medical University
Author for correspondence.
Email: uulevsafyanov@gmail.com
ORCID iD: 0009-0008-6273-230X
Russian Federation, 1/1 Pogodinskaya street, 119435, Moscow
Maria N. Pikuza
I.M. Sechenov First Moscow State Medical University
Email: mashenkapikuza@gmail.com
ORCID iD: 0000-0002-2680-9372
Russian Federation, 1/1 Pogodinskaya street, 119435, Moscow
Roman N. Kostin
I.M. Sechenov First Moscow State Medical University
Email: oman.kostin.2002@gmail.com
ORCID iD: 0009-0004-1132-1288
Russian Federation, 1/1 Pogodinskaya street, 119435, Moscow
Petr V. Tsarkov
I.M. Sechenov First Moscow State Medical University
Email: tsarkov@kkmx.ru
ORCID iD: 0000-0002-7134-6821
SPIN-code: 7570-0664
MD, Dr. Sci. (Med.), professor
Russian Federation, 1/1 Pogodinskaya street, 119435, MoscowReferences
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