A Dermoid Cystic Lesion on the Forehead- A Case Report

Case Report

J Dent & Oral Disord. 2018; 4(3): 1092.

A Dermoid Cystic Lesion on the Forehead- A Case Report

Surabhi V*, Shetty N, Vachhani D, Bangera D, Athiramol CK and Boricha V

Department of Oral & Maxillo-Facial Surgery, A.J. Institute of Dental Sciences, Kuntikana, Mangaluru, Karnataka, India

*Corresponding author: Surabhi V, Department of Oral & Maxillo-Facial Surgery, AJ Institute of Dental Sciences Kuntikana, Karnataka, India

Received: February 19, 2018; Accepted: March 14, 2018; Published: March 21, 2018


The epidermoid cyst is a development cyst, filled with keratin and entrapped by stratified squamous epithelium. Epidermoid cyst is histological a benign lesion that usually affects the scalp regions, face, neck and back. They are usually asymptomatic and its etiology is mostly related to trauma, as well as the entrapment of epithelial rests during embryonic fusion. This study aims to present a case report of a 13-year-old patient, with an epidermal cyst in the anterior fontanelle region.

Keywords: Epidermoid cyst; Fore head; Ultrasonography


Epidermoid cysts are non-odontogenic cysts which is benign in nature. These rare lesions are derived from germinal epithelium and can be seen throughout the body, particularly in sites where embryonic elements fuse together. Mostly occurring in the ovaries and testicles, 7% occurring in the oro-facial region and 1.6% in the oral cavity, and represents 0.01% of all cysts in the oral cavity. Male to female ratio is 3:1 [1,2]. It is commonly asymptomatic, however, it may become symptomatic due to secondary infection. They contain a central core of keratin proteins, desquamating cells and cholesterol, and lined with stratified squamous epithelium. Epidermoid cysts commonly spread along pathways of least resistance such as natural cleavage planes and anatomic canals, extend into more than one cranial fossa and envelop the neural and vascular structures [3].

Case Presentation

A medically fit, 13-year-old patient came to our department seeking help for an asymptomatic mass over the fore head, which was present since childhood, and had increased in size over the years. Patient complained of unaesthetic appearance of the face because of the lump. There was no family history either. On detailed examination, the lesion was single, well-defined seen in the forehead at the midline, measuring about 2x2 cm in its greatest diameter. Skin over the swelling was smooth and of the normal color without any secondary changes. It was firm in consistency, slightly compressible, non-tender without local rise in temperature. No dental abnormality was detected. Based on the clinical examination a provisional diagnosis of dermoid cyst was given. Epidermoid cyst, Lipoma, and sebaceous cyst were considered under differential diagnosis of this lesion. Ultra sound of the lesion was carried out which revealed well defined heterogeneously hyperechoic lesion measuring approximately 25x8x27 mm in the subcutaneous plane of the forehead which was seen extending intracranially through defect in adjacent frontal bone measuring 4mm. Features were suggestive of epidermoid cyst.

Therefore, based on the clinical information and laboratory test, it was decided to perform an excisional biopsy of the lesion. The excision of the lesion was performed under local anesthesia. Ring block local infiltration was given around the lesion, patient was painted and drapped aseptically. Horizontal incision was given over the lesion, blunt dissection was done and cyst was completely excised and was sent for histopathological examination which revealed it to be an epidermoid cyst. There were no surgical complications and the patient recovered without complaints and was very happy with aesthetical results.