The patient went on to have resection and cranioplasty. 

Histology

MICROSCOPIC DESCRIPTION: Paraffin sections show a cyst lined by a thin layer of squamous epithelium. A small amount of keratin is noted within the cyst lumen. No appendageal structures are identified and there are no mesenchymal elements. The cyst wall is composed of vascular granulation tissue containing patchy infiltrates of plasma cells, lymphocytes and and CD68+ histiocytes. Small trabeculae of viable bone are present within this tissue. The features are of an epidermal cyst. No evidence of tumour is seen.

DIAGNOSIS: Epidermal cyst.

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