Epidermal inclusion cyst (nape of neck)

Case contributed by Maulik S Patel
Diagnosis probable

Presentation

Presented with a complaint of painless swelling in nape of the neck for the last 6 - 7 yrs. History of gradual increase in the lesion size

Patient Data

Age: 60 years
Gender: Male
ultrasound

There is a mid-line soft tissue mass lesion in the nape of the neck; measuring about 70 x 40 x 30 mm. It is in the subcutaneous plane and abutts skin. The lesion is encapsulated. It shows relatively homogeneous echopattern with few linear tiny anechoic cleft like foci. The lesion is avascular showing doppler artifact at very high PRF.  There is the presence of posterior acoustic enhancement. With a standoff gel pad, there is a hypoechoic tract from lesion to skin favoring a punctum.

 

Case Discussion

A patient presented a history of a slow-growing, painless mass lesion in the nape of the neck swelling. Ultrasound shows an encapsulated, avascular lesion abutting the undersurface of the skin. There is a tiny hypoechoic tract from lesion to the skin favoring a punctum.

The ultrasound findings very much favor the lesion being an epidermal inclusion cyst. However, the histopathology report is not available.

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