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December 2016

A Cyst Misinterpreted on Airport Scan as Security Threat

Author Affiliations
  • 1Cooper Medical School of Rowan University, Marlton, New Jersey
JAMA Dermatol. 2016;152(12):1388. doi:10.1001/jamadermatol.2016.3329

Given the recent airport terrorist bombings in Brussels and Istanbul, security is of paramount concern. Benign dermatologic lesions may trigger suspicion for contraband.

Report of a Case

An airport traveler had a 1.5-cm epidermal inclusion cyst detected by an airport scanning device prompting a personally invasive security search for hidden explosives. Subsequently, the traveler obtained a medically explanatory letter to present to airport security agents on future journeys.


Many airports use a full-body backscatter x-ray scanning device that creates a body image able to detect weapons and contraband hidden in clothing and skin. The radiation doses emitted during these scans are extremely small, equivalent to that received during 3 to 9 minutes of normal daily living.1

In larger airports millimeter-wave scanners, using radio frequencies instead of x-rays to detect concealed objects, are replacing backscatter devices. If a possible threat is detected, a yellow box appears at the suspected anatomical site on a mannequin-like image. Further security measures may then include a physical pat down. Newer scans may be completed in less than 2 seconds, substantially expediting the screening process.2

Naraynsingh et al3 reported the case of a 68-year-old man with an asymptomatic, easily reducible, left inguinoscrotal hernia who had a similar experience at a US airport. He was humiliated by the interrogation and examination of his genital region and opted to have an inguinal herniorrhaphy. The authors’ prediction that other disorders such as lipomas or cysts could provoke a similar scenario proved prescient.3

For as long as x-ray scanners are in use, it is essential that both screeners and passengers be knowledgeable about disorders that may be misconstrued as terroristic threats, thereby avoiding potential humiliation, embarrassment, and perhaps unnecessary surgery.

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Article Information

Corresponding Author: Warren R. Heymann, MD, Cooper Medical School of Rowan University, 100 Brick Rd, Marlton, NJ 08053 (wrheymann@gmail.com).

Published Online: September 7, 2016. doi:10.1001/jamadermatol.2016.3329.

Conflict of Interest Disclosures: None reported.

Mehta  P, Smith-Bindman  R.  Airport full-body screening: what is the risk?  Arch Intern Med. 2011;171(12):1112-1115.PubMedGoogle ScholarCrossref
Keyser  J. TSA replaces x-ray scanners at seven major airports. http://www.thehour.com/nation/article/TSA-replaces-X-ray-scanners-at-seven-major-8203810.php. Accessed June 15, 2016.
Naraynsingh  V, Cawich  SO, Maharaj  R, Dan  D.  Inguinal hernia and airport scanners: an emerging indication for repair?  [published online December 3, 2013].  Case Rep Med. doi:10.1155/2013/952835.PubMedGoogle Scholar