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Swellings 1

The document discusses various types of cysts and dermoids, detailing their definitions, classifications, clinical features, effects, and treatment options. It covers true and false cysts, different types of dermoids, and specific cysts like thyroglossal and ependymal cysts. The document also highlights the importance of differential diagnosis and potential complications associated with these conditions.

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kousartasneem695
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0 views32 pages

Swellings 1

The document discusses various types of cysts and dermoids, detailing their definitions, classifications, clinical features, effects, and treatment options. It covers true and false cysts, different types of dermoids, and specific cysts like thyroglossal and ependymal cysts. The document also highlights the importance of differential diagnosis and potential complications associated with these conditions.

Uploaded by

kousartasneem695
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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SWELLINGS

BY:-KOUSAR TASNEEM
CYSTS
• Collection of fluid in a sac lined by epithelium
or endothelium.
TRUE CYST FALSE CYST

•Cyst wall lined by •Cyst wall does not have


epithelium/endothelium epithelial lining.
/granulation tissue.
•Fluid is usually serous or •Fluid collection occurs
mucoid derived from as a result of exudation
secretion of lining. or degeneration.
CLASSIFICATION
 CLINICAL FEATURES:-
• Hemispherical swelling
• Smooth,fluctuant,nontender,well localised.
• Transiluminant
• Can be single or multiple.
 EFFECTS OF CYST:-
• Compression of adjacent structures.
• Infection ,sinus formation ,haemorrhage.
• Torsion[ovarian cyst]
• Calcification[hyatid cyst,cysticercosis]
• Cachexia[malignant ovarian cyst].
DERMOIDS
Mainly 4 types:-
• Sequestration Dermoids
• Tubulodermoids
• Implantation Dermoid
• Teratomatous Dermoid
SEQUESTRATION DERMOIDS
• Occurs at the line of embryonic fusion,due to
inclusion of epithelium beneath the surface
• Later gets sequestered forming a cystic swelling.
• Congenital type
• Common sites are:-
1. forehead,neck,postauricular dermoid
2. external angular dermoid
3. root of nose,sublingual dermoid
4. anywhere in the midline or in line of fusion
FEATURES:-
Painless swelling
Smooth,soft,non-tender,fluctuant
Nontransilluminating
Free skin,often adherent into deeper plane
Resorption and indentation of bone.
Impulse on cough[when extend to
intracranial]
TYPES OF SEQUESTRATION DERMOIDS:-
1. ANGULAR DERMOIDS:-
• EXTERNAL ANGULAR DERMOIDS
 Situated over the external angular process of frontal
bone
 Extends over outer extremity of eyebrow.
 May extend into lacrimal gland.
• INTERNAL ANGULAR DERMOIDS
 Situated in medial position near the root of nose.
 Occurs in frontoethmoidal/frontolacrimal suture
line.
 Mimics swelling from lacrimal sac/mucocele/frontal
sinus
2.MIDLINE DERMOIDS:-
3. POST-AURICULAR DERMOID:-
Occurs just behind the ear along the squamo-
mastoid line.
Large in size but does not extend
intracranially.
4.PREAURICULAR DERMOID:-
Occurs just infront of the ear at
squamotympanic suture line.
Mimics sebaceous cyst, lipoma.
5. DERMOID EAR:-
From one of the six developmental ear
tuburcles.
 DIFFERENTIAL DIAGNOSIS:-
Sebaceous cyst,lipoma,neurofibroma
 INVESTIGATIONS:-
X-ray of skull or part
CT scan of skull or part
 TREATMENT:-
Exicision is done under GA.
Neurosurgical approach is required by raising cranial
osteocutaneous flaps.
 COMPLICATION:-
• Infection ,haemorrhage and rupture
• Surface ulceration,calcification
• Pressure effects if intracavitary extension
• Malignant transformation
TUBULODERMOIDS
• Arises from embryonic tubular structures
• Due to accumulation of secretions of lining of
unobliterated portion of congenital
ectodermal tube/duct.
THYROGLOSSAL CYST
. Due to persistent thyroglossal duct during. development of
thyroid gland.
 EPENDYMAL CYST
• Originate from neuroectodermal cyst
• Benign neuroepithelial cysts lined by
ependymal cells.
• Most commonly located in parenchyma
• Large cyst can cause obstructive
hydrocephalous.
 POSTANAL DERMOID
• Develops from post anal gut[remnant of
neuroenteric canal]
• Symptoms occurs when it gets large[pressure
symptoms]
• Treated by complete excision,coccyx may need
to be removed for easy access.
 URACHAL CYST
• Arises from remnant of urachus.
• Presents in midline at lower abdomen as
extraperitoneal mass.
• Can get infected/rupture into umbilicus /
peritoneal cavity/caliculi can
form/adenocarcinoma can develop.
IMPLANTATION DERMOID
• Acquired cyst
• Due to minor pricks or trauma
• Epidermis gets buried into deeper subcutaneous
tissue which causes reaction and cyst formation
• Common in fingers ,toes and feet
• Swelling is painless, smooth ,soft ,mobile, tensely
cystic ,nontransilluminating and adherent to skin
• Contains only squamous epithelium,without hair
follicle/sweat or sebaceous gland.
• COMPLICATIONS:-
infection,rupture and pressure effects over
digital nerves
• DIFFERENTIAL DIAGNOSIS:-
lipoma,bursa
• TREATMENT:-
excision under local anaesthesia
TERATOMATOUS DERMOID
• Arises from all germinal layers.
• Occurs in ovary ,testis ,retropertioneum,
mediastenum.
• Contains hair,teeth,cartilage,sebum and
muscle.
• Can be benign or malignant.
THANK YOU

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