EURORAD ESR

Case 13109

Intraosseous epidermal cysts

Author(s)
Bello Baez Adán, Nieto Morales Maria Luisa, Melgar Villaplana Leticia, Cavada Laza Arsenio, Eiroa Daniel, Benitez Rivero Sonia, Vázquez Sánchez Víctor, Nuñez Maria pilar, Reboso Luis Enrique.

Ctra. Gral. del Rosario, 145, 38010 Santa Cruz de Tenerife
 
Patient
female, 35 year(s)
 
 
  • Figure 1
    X Ray Images, AP and lateral views.
     

    AP X ray. Eccentric lytic lesion with sclerotic borders and cortical defect with adjacent soft tissue swilling

     
    Area of Interest: Trauma; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Trauma;

    Lateral view. Dorsal cortical defect.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
  • Figure 2
    MRI
     

    Intermediate SI on axial T1WI is probably due to the cholesterol component of the lesion (long arrow). Low Signal intensity is due to calcium from cortical destruction (short arrow).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Trauma;

    Axial T2WI FSE fat sat. Low central intensity signal which correspond to Keratin and calcium (Arrow) inside the cyst lesion.

     
    Area of Interest: Trauma; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Trauma;

    Coronal T2 FSE fat sat WI. Heterogeneous lesion predominant high SI peripherally (arrow) and low signal intensity in the center (fluid and keratin-calcium respectively).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Trauma;

    T1-weighted contrast enhanced subtraction axial image of the tumor demonstrating Peripheral enhancement (Arrow).

     
    Area of Interest: Musculoskeletal bone; Trauma; Imaging Technique: Experimental; MR; Procedure: Diagnostic procedure; Special Focus: Trauma;

    The axial diffusion weighted image shows mixed signal intensity mass

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Trauma;

    ADC: the apparent diffusion coefficient value of the mass was 1.35 × 10−3 mm2/s.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Trauma;
     
     
  • Figure 3
    Histology

    Laminated keratin in the cyst lined by stratified squamous epithelium. (Hematoxylin-eosin stain, original magnification, 10×).

     
    Area of Interest: Musculoskeletal system; Trauma; Imaging Technique: Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Special Focus: Trauma;
     
     
AP X ray. Eccentric lytic lesion with sclerotic borders and cortical defect with adjacent soft tissue swilling
 
Lateral view. Dorsal cortical defect.
 
Intermediate SI on axial T1WI is probably due to the cholesterol component of the lesion (long arrow). Low Signal intensity is due to calcium from cortical destruction (short arrow).
 
Axial T2WI FSE fat sat. Low central intensity signal which correspond to Keratin and calcium (Arrow) inside the cyst lesion.
 
Coronal T2 FSE fat sat WI. Heterogeneous lesion predominant high SI peripherally (arrow) and low signal intensity in the center (fluid and keratin-calcium respectively).
 
T1-weighted contrast enhanced subtraction axial image of the tumor demonstrating Peripheral enhancement (Arrow).
 
The axial diffusion weighted image shows mixed signal intensity mass
 
ADC: the apparent diffusion coefficient value of the mass was 1.35 × 10−3 mm2/s.
 
Laminated keratin in the cyst lined by stratified squamous epithelium. (Hematoxylin-eosin stain, original magnification, 10×).
 
 
 
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