Typically appearing dermoid cyst of neck in atypical location - A case report
Section
Head & neck imaging
Case Type
Clinical Cases
Authors
Madhuri Ghate, Rashmi Kotkar, Amol Gulhane
Krsna Diagnostics PVT LTD; Pawana Nagar Housing Society 411033 Chinchwad, India; Email:madhuri.ghate01@gmail.com
Patient
24 years, female
Categories
Procedure Education ; Special Focus Cysts;
FIGURE 1
Axial unenhanced CT neck
Axial non-contrast image of neck showing a well defined hypodense lesion(red arrow) in the left paratracheal region containing multiple fat density globules (blue arrow) giving the characteristic 'sack of marbles' appearance.
Clinical History
A 24-year-old woman presented with a slow-growing swelling on the left side of her neck present for 6 months.
Imaging Findings
Axial pre- (Fig. 1) and post-contrast (Fig. 2) CT of the neck was performed with coronal (Fig. 3) and sagittal (Fig. 4) reconstructions. This showed a well-defined, thin-walled, subtly enhancing unilocular hypodense lesion (red arrow), containing multiple small fat density globules (blue arrow), with a characteristic 'sac of marbles' appearance. The lesion was located in the infrahyoid neck (hyoid bone-yellow arrow), in the left paratracheal region. It measured approximately 42 x 32 x 28mm (CC x Trans x AP) in size. The lesion lay superolateral to the left lobe of the thyroid gland, causing mild compression and indenting the posterior border of the left submandibular gland (green arrow). It was positioned inferior to the left mylohyoid muscle and did not reach the skin. No evidence of calcification was seen.
Discussion
Differential Diagnosis List
Dermoid cyst of the neck.
Lipoma
Epidermoid cyst
Final Diagnosis
FIGURE 2
Axial post-contrast CT neck
Sagittal reformatted image showing the infrahyoid location (Hyoid bone -yellow arrow) of the dermoid cyst (red arrow)
FIGURE 3
Sagittal reformatted image- post-contrast CT neck
Axial post-contrast image of the neck showing subtle peripheral enhancement (red arrow).
FIGURE 4
Coronal reformatted image- post-contrast CT neck
Coronal reformatted image showing the dermoid cyst (red arrow) abutting the left submandibular gland (green arrow).