1 / 16

A Rare Case Of Parotid Dermoid

A Rare Case Of Parotid Dermoid. Dr. Nikesh M Gosrani PG RESIDENT, IGGMC, NAGPUR. HISTORY. 19 yr old male c/o swelling on right parotid region since 9 years Increasing gradually. HISTORY. Past history - not significant Family history - not significant

jadon
Télécharger la présentation

A Rare Case Of Parotid Dermoid

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A Rare Case Of Parotid Dermoid Dr. Nikesh M Gosrani PG RESIDENT, IGGMC, NAGPUR

  2. HISTORY • 19 yr old male • c/o swelling on right parotid region since 9 years • Increasing gradually

  3. HISTORY • Past history - not significant • Family history - not significant • Personal history - chronic gutka chewer

  4. GENERAL EXAMINATION • GC- mod • Afebrile • P-74/min • BP- 120/80 mmHg • No pallor/clubbing/cyanosis/icterus/edema • No significant cervical lymphadenopathy

  5. Systemic Examination • Respiratory system -NAD • Cardiovascular system - NAD • Gastrointestinal system - NAD • Central Nervous System - NAD

  6. LOCAL EXAMINATION • Swelling in rt parotid • size 4x3cm • Soft ,cystic ,mobile non • Fluctuant • No s/o inflamation • Overlying skin normal

  7. LOCAL EXAMINATION • Facial nerve normal examination b/l • Oral cavity -NAD • Nose -NAD • Ear -NAD

  8. INVESTIGATIONS • Hb - 12.9 gm% • TLC - 8800/mm N-56%,L-38%,E-3%,M-3% • Bld. Urea - 16 mg% • Urine – N.

  9. FNAC - inconclusive • USG LOCAL- mild heterogenous lesion in right parotid size 4x3x4 cm on superficial lobe ? Pleomorhic adenoma • Differential Diagnosis : Rt parotid pleomorphic adenoma Warthins tumor DermoidBranchial cleft cyst Branchial pouch cyst • Advice operation :superficial parotidectomy

  10. Intraoperational findings : • Mass 4x3x4 • Unilocular cyst • Opaque grey white • Dense fibrous wall

  11. Histopathology report : • Cyst wall - stratified squamous • Underlying sebaceous glands • With hair follicles • s/o d=Dermoid

  12. Discussion • Also called Epidermal cyst. • Dermoid cyst of head & neck rare (6.9% of all dermoid cyst) Orbit 49.5%, nose 12.6%, submental & submaxillary region 23.3 % remainder 14.6% • Initially Based on pathogenesis & microscopic appearance • Congenital dermoid - teratoma type(ovaries & testes) • Acquired dermoid cyst (hands & other exposed parts) • Congenital inclusion dermoid (head & neck). a.nasooptic groove b.nose (frontonasal plate) c.submental & submaxillary region d.miscellaneous group(midventral or middorsal line )

  13. Discussion • Now 4 types of Dermoid – Sequestration dermoid Implantation dermoidTubulodermoidTeratomatousdermoid • Sequestration – inclusion of epithelium burried at line of embryonic fusion eg; near head & neck • Implantation dermoid- indriven epithelium beneath skin due to puncture injury eg ; exposed part of body • Tubulodermoid– cyst from unobliterated portion of congenital ectodermal duct or tube eg;thyroglossalcyst,post anal cyst,ependymal cyst in brain • Teratomatoiddermoid – from totipotent cells eg; ovary,testis

  14. Discussion • Parotid dermoid – rare entity • Clinicallydifficultto make diagnosis • Physical examnation – no characterstic findings • Isolated mass, near surface or within gland • Histologically –keratization of squamous epithelium, a/w skin appendages – hair follicles,sweat glands, sebaceous gland • Parotid dermoid relatively well encapsulated • Simple excision may recur so superficial parotidectomy is advisable

  15. Conclusion • Parotid extremely rare • Due to rarity & absence of pathognomonic findings , difficult to diagnose preoperatively • Must be differentiated from malignant tumors & other cystic lesion • Recur after simple excision so superficial parotidectomy is advisable

More Related