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Koji Yoshimoto, Shunji Nishio, Satoshi Suzuki, Masashi Fukui, and Kanehiro Hasuo

Dermoid tumors, such as dermoid cysts or mature teratomatas that contain dermal elements with sebaceous glands, produce fat or oil within their capsules. When such tumors rupture, fatty or oily globules thus escape into the ventricles and/or into the subarachnoid spaces. 1–5 We report two such cases. The first case is that of a 26-year-old man who developed a dull headache and diplopia. Computerized tomography (CT) and magnetic resonance (MR) imaging revealed a dermoid cyst in the middle fossa. At surgery oily globules were noted to be floating and moving

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Doo-Sik Kong, Stephanie Ming Young, Chang-Ki Hong, Yoon-Duck Kim, Sang Duk Hong, Jung Won Choi, Ho Jun Seol, Jung-Il Lee, Hyung Jin Shin, Do-Hyun Nam, and Kyung In Woo

was 51.7 years and the range was 18–73 years. There were 4 men and 14 women. Twelve patients had sphenoorbital meningioma extending along the sphenoid ridge and orbit with or without cavernous sinus involvement; 3 patients had malignant disease (osteosarcoma, plasmacytoma, and sebaceous gland carcinoma); and 3 other patients had one of the following: intraconal schwannoma, cystic teratoma, and fibrous dysplasia. Ten patients had primary lesions and 8 patients had recurrent tumors. Thirteen tumors were intradural lesions, while 5 tumors were extradural lesions

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Joachim Oertel, Jürgen Piek, Jan-Uwe Müller, Silke Vogelgesang, Rolf Warzok, and Robert Michael Gaab

substance and hairs inside. Histologically, the neoplasm appeared to be a classic dermoid cyst including sebaceous glands ( Fig. 3 left ); however, there were also findings of a squamous cell carcinoma with atypical polymorphic epithelial cells, necrosis, frequent mitoses, and focal cornification ( Fig. 3 right ). The patient's postsurgical course was uneventful, with transient deterioration of her cerebellar signs. Extensive screening for a primary squamous cell carcinoma revealed no other tumor. At 3-month follow up, the patient remained tumor free. Fig. 1

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Nosiru A. Ojikutu and Victor P. N. Mordi

. Beneath the epithelium could be seen some large structures containing clear spaces, very reminiscent of sebaceous glands. Inside the cyst, keratin debris was found, and in areas where stratified epithelium was not visible, some foam cells could be seen adherent to the cyst wall. There was no evidence of malignancy ( Fig. 3 ). Histologically, the tumor was diagnosed as a dermoid cyst. The postopertive course was uneventful. Fig. 2. Case 1. Left: The unopened cystic tumor. Right: The cyst was filled with pastry-like material with a few hairs in the left half

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David Krahulík, Marta Karhanová, Miroslav Vaverka, Světlana Brychtová, and Dagmar Pospíšilová

miniaturized. There were also 2 small sebaceous glands in the lesion ( Fig. 2 ). FIG. 1. Photograph showing a cluster of dark hairs on the lateral quadrant of the anterior surface of the left upper eyelid, a typical clinical picture of ectopic cilia. Figure is available in color online only. FIG. 2. Photomicrograph showing an abnormally arranged cluster of hair follicles embedded in a desmoplastic stroma, without signs of inflammation. The follicles have an appearance of the anagen phase of the hair growth cycle, with the hair shaft in the center (wide

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Daniel Refai, Richard J. Perrin, and Matthew D. Smyth

lesion are adnexal structures (such as hair follicles, apocrine glands, and sebaceous glands) required for a diagnosis of dermoid cyst. H & E, original magnification × 200. This patient's presentation is remarkable because the cause of the epidermoid cyst was likely iatrogenic from the previous lumbar puncture attempts. He had no clinical or radiographic evidence of spinal dysraphism to suggest a congenital etiology of the epidermoid cyst. The history of multiple unsuccessful lumbar punctures as a neonate and the location of the lesion strongly suggest an

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Franz E. Glasauer, Laurence F. Levy, and William C. Auchterlonie

extension. The contents of the cysts were mostly clear fluid or occasionally turbid with some caseous or white floating particles. On one occasion a hair was also found in the fluid. A chemical analysis of the fluid of three cysts revealed a very low protein and sugar content ( Table 2 ). On histological examination the cysts were reported as dermoid cysts, the walls of which contained hair follicles and sebaceous glands ( Fig. 3 ). TABLE 2 Laboratory findings of fluid contents Age, Sex Protein (mg%) Glucose (mg%) Globulin 12

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Roberto Spiegelmann, Edgardo Schinder, Mordejai Mintz, and Alexander Blakstein

throughout. A Vater-Pacini corpuscle was visible in one section ( Fig. 2 ). Bundles of striated muscle fibers, longitudinally arranged, were seen in the center of the appendage. Normal skin with hair follicles, sebaceous glands, and sweat glands covered the tail. No bone was found. The histological findings are consistent with those reported by other authors. 1, 4 Fig. 2. Photomicrograph of a section of the tail. H & E, × 100. Discussion In all reported cases, the vestigial human tail lacks bone, cartilage, notochord, and spinal cord. It is unique in

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Susumu Wakai, Hiromu Segawa, Shigemi Kitahara, Takao Asano, Keiji Sano, Riuji Ogihara, and Shin Tomita

meninges were thickened and opaque, which was compatible with the finding of purulent meningitis ( Fig. 1 ). Histologically, the tumor was composed of keratinized squamous epithelium, sebaceous glands, fat tissues, and columnar epithelium, with goblet and Paneth cells indicating intestinal structures ( Fig. 2 upper left ). In addition to these three germinal components, the tumor contained germinomatous elements, which infiltrated into the parenchyma of the surrounding brain ( Fig. 2 lower left ). The histological diagnosis was made of a pineal teratoma with some

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Marco A. Amendola, William B. Garfinkle, Bernard J. Ostrum, M. Richard Katz, and Richard I. Katz

noted. On histological examination, the interrupted cyst wall was seen to be lined by stratified squamous epithelium. Within the underlying collagenous tissue, skin appendages consisting of hair follicles and many sebaceous glands could be recognized. Postoperative Course The patient had an uncomplicated postoperative course with full recovery. He has had no further seizure activity. Discussion Plain skull x-ray visualization of an intracerebral dermoid cyst as a radiolucent mass has been a rare occurrence. Only two cases have been reported 11