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Dermoid cyst in left temporal fossa

Case contributed by Shervin Sharifkashani
Diagnosis almost certain

Presentation

Soft tissue bulge within anterior left side temporal fossa.

Patient Data

Age: 5 years
Gender: Female

Well-defined cyst in the superficial part of the anterior left temporal fossa that has impression deformity on adjacent left orbit lateral wall, containing fluid isodense with eye vitreous. The cyst also has a mild impression on the anterior lateral margin of the left temporalis muscle.

Case Discussion

A dermoid cyst is infrequently seen in the temporal fossa and usually involves adjacent bone and has an impression on temporal muscle and can be seen simultaneously with a diploic and orbital dermoid cyst. Temporal fossa dermoid cyst rarely presents as a discharging incomplete dermal sinus and rarely has intracranial extension.

The evaluation of adjacent bony structure for the cyst management and follow-up is nicely depicted on orbital and cranial non-contrast MDCT. Complete evaluation from the point of presence and extension of accompanying sinus tract is critical, which is best depicted on MRI with and without contrast.

The treatment of choice is complete surgical resection with careful follow-up.

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