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Radiology Forum
August 1999

Quiz Case 2

Author Affiliations
 

R. NICKBRYANMDS. JAMESZINREICHMD

Arch Otolaryngol Head Neck Surg. 1999;125(8):915. doi:

Intradiploic epidermoid cysts are insidious lesions. They most commonly present in the third or fourth decade of life as a long-standing painless subcutaneous scalp swelling covered with normal skin.1 Bony epidermoid cysts are mainly located in the skull, although other locations, including the mandible, maxilla, temporomandibular joint, distal phalanges, tibia, and femur, have been described.2 These inclusion cysts are generally asymptomatic, but if symptoms are associated, they most commonly consist of headache and tenderness. Intracranial hypertension, seizures, and focal neurologic signs have been described in patients with large cysts.3 In the series of Arana et al,1 the average cyst diameter at presentation was 2.9 cm, and the most common locations were parietal, frontal, and orbital. Three types of bony change have been described: fossa formation with bone attenuation, bone sclerosis, and bone erosion.4

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