Presentation
Presented with altered mental status and history of lung cancer. Also has a large soft tissue mass in the occipital region since childhood.
Patient Data
Axial and sagittal MRI images demonstrate a large well circumscribed iso-T1, intermediate to high T2 signal intensity mass arising in or just beneath the skin without restricted diffusion. On post-contrast images there is only thin discontinuous peripheral enhancement. Also, note a ring-enhancing lesion in the right occipital region, a biopsy-proven metastatic lung carcinoma.
Scalp mass, biopsy-proven epidermal inclusion cyst.
Case Discussion
The mass was excised. Pathology report came back as epidermal inclusion cyst. Epidermal inclusion cysts (epidermoid cysts) most frequently occur on the face, scalp, neck, and trunk. Most arise from the follicular infundibulum.They are usually benign, however rare cases of malignant transformation, possibly due to chronic irritation or repetitive trauma to the epithelial lining of the cyst, have been reported.