Acquired Dermoid Cysts within Subcutaneous Scar Tissue.

Kim, Hyoung Jin; Burm, Jin Sik; Pyon, Jai Kyong; Kim, Yang Woo

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Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(4):507-510.
Published online July 1, 2007.

Acquired Dermoid Cysts within Subcutaneous Scar Tissue.

Hyoung Jin Kim, Jin Sik Burm, Jai Kyong Pyon, Yang Woo Kim

Department of Plastic and Reconstructive Surgery, Mokdong Hospital, Ewha Womans University, Seoul, Korea. jsburm@ewha.ac.kr

Abstract

PURPOSE
Dermoid cysts are almost always caused by congenital events. The most widely accepted pathogenesis is that the cysts are dysembryogenetic lesions that arise from ectodermic elements entrapped during the midline fusion. We report a rare case of dermoid cyst, which occurred not congenitally but newly in the subcutaneous scar tissue secondary to trauma. METHODS: A 26-year-old man had a deep submental laceration caused by a car accident and got a primary wound closure 16 months ago. There were 18 cm-long submental hypertrophic scar and newly developed palpable masses inside the subcutaneous layer at the center of the scar. Initial impression was an epidermal cyst or a thyroglossal duct cyst. Ultrasonographic finding showed two cystic masses inside the scars at the submental area, but impressed dermoid cysts. The cystic masses were completely removed with W-plasty and histological examination were followed.
RESULTS
The histological diagnosis was dermoid cysts which were mainly composed of keratotic squamous epithelium in their inner surface linings and numerous skin appendages such as sebaceous glands, sweat glands, and hair follicles in their cystic lumens histopathologically. During the follow-up period of 25 months, there was no recurrence of any subcutaneous mass in the site of scar.
CONCLUSION
We report a very unusual case of dermoid cysts developed by an acquired cause, considering that the accidental inclusion of deep skin elements caused by a trauma can be a critical origin of dermoid cysts.

Keywords: Dermoid cyst; Traumatic implantation

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