Epidermoid cyst

Case contributed by Ammar Ashraf

Presentation

Lower back swelling for 10 years. No pain or discharge.

Patient Data

Age: 35 years
Gender: Male
ultrasound

Three well-defined oval-shaped homogeneous hypoechoic masses lying next to each other, in the subcutaneous soft tissues overlying the sacrum. No calcifications or internal vascularity is seen in these lesions.

mri

Well-defined multiloculated subcutaneous cystic lesions at the level of sacrum. These lesions are hypointense on T1, hyperintense on T2 and show mild diffusion restriction. No fat, calcifications, solid component or internal enhancement is seen in these lesions. No communication is seen with the spinal canal.

Photo

The lesion was excised under local anesthesia and was proven to be an epidermoid cyst on histopathology.

Case Discussion

Well-defined multiloculated subcutaneous cystic lesions at the level of sacrum; possible differentials are epidermal inclusion cyst or lymphatic malformation.

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