J Korean Assoc Oral Maxillofac Surg.  2011 Jun;37(3):237-240. 10.5125/jkaoms.2011.37.3.237.

Iatrogenic epidermoid cyst in the parotid gland: A case report

• Lee CS
• Kim HK
• Lim JH
• Jeon KJ
• Huh JK

• KMID: 2189785
• DOI: http://doi.org/10.5125/jkaoms.2011.37.3.237

Abstract

Epidermoid cysts presents as a nodular and fluctuant subcutaneous lesion beneath the skin and are most common in acne-prone areas of the head, neck and back. This cyst often arises after localized inflammation of the hair follicle and occasionally after the implantation of epithelium following trauma and surgery including a biopsy procedure. It is often associated with Gardner syndrome, particularly before puberty. The lesion is normally treated by a surgical excision or enucleation, and recurrence is uncommon. A 27 year old woman complained of a swelling of the left parotid gland when she visited our clinic. A cystic lesion was found in the left parotid gland from the high signal intensity on the MR images. Ultrasonography showed that the cystic lesion was heterogeneous echogenic. Six months earlier, botulinum toxin was injected in her left masseter muscles six months earlier and progressive swelling of the left parotid area was noticed four months after treatment. The lesion was surgically removed. It was encapsulated by a thin wall and filled mainly with keratin. The final diagnosis was an epidermoid cyst.

Keyword

Epidermoid cyst; Parotid gland; Botulinum toxin; Injections

MeSH Terms

Biopsy
Botulinum Toxins
Epidermal Cyst
Epithelium
Female
Gardner Syndrome
Hair Follicle
Head
Humans
Inflammation
Keratins
Masseter Muscle
Neck
Parotid Gland
Puberty
Recurrence
Skin
Botulinum Toxins
Keratins

Figure

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  Fig. 1. Preoperative photograph. Swelling of the left parotid area (arrow) is seen.

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  Fig. 2. A. T1-weighted MR image.(coronal view) It shows a low signal intensity lesion in the left parotid gland with 1.7 × 1.1 cm size. B. T2-weighted MR image.(coronal view) It shows a high signal intensity cystic lesion and relatively low signal intensity materials within the lesion in the left parotid gland.(See the arrow) C. T2-weighted MR image.(axial view) The lesion is located in the parotid gland, not masseter muscle.(arrow)

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  Fig. 3. About 3 cm heterogeneous echogenic cystic lesion in the left parotid gland is observed on ultrasonogram.

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  Fig. 4. Removed cystic sac and cheese like material (arrow) filled in the sac.

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  Fig. 5. Histologic findings.(H-E stain, ×100) Squamous epithelial lining with keratin formation (arrow) is observed.

Reference

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