Epidermal Cyst of the Nasal Tip Presenting as Foreign Body Reaction

이물 반응으로 오인된 비첨부 표피 낭종

  • Choi, Chang Yong (Department of Plastic and Reconstructive Surgery College of Medicine, Soon Chun Hyang University) ;
  • Choi, Hwan Jun (Department of Plastic and Reconstructive Surgery College of Medicine, Soon Chun Hyang University)
  • 최창용 (순천향대학교 의과대학 성형외과학교실) ;
  • 최환준 (순천향대학교 의과대학 성형외과학교실)
  • Published : 2009.01.15

Abstract

Purpose: Epidermoid cyst may be congenital or acquired. Acquired cysts are most commonly of traumatic origin and result from an implantation or downward displacement of an epidermal fragment. Traumatic epidermoid cysts are rare tumors occurring on the nasal tip, especially resulting aesthetic procedure. So, we report a rare case of an iatrogenic epidermoid cyst in the nasal tip following rhinoplasty. Methods: A 44 - years old man had undergone rhinoplasty for several times. First time, the previous augmentation rhinoplasty and wedge osteotomy were performed nineteen months ago, lastly implant removal and unknown filler injection were performed one year ago at another local clinic. He had induration and tenderness on nasal tip and dorsum continued for 3 months. We thought that it caused by foreign body reaction with residual alloderm in nose. For removal of residual alloplastic material, open approach using transcolumellar incision was done. But, incidentally we found cystic mass on the nasal tip. Results: The findings were of an $0.8{\times}0.5{\times}0.5cm$ sized round cystic mass containing cream coloured material with a thick cheese - like consistency. The mass was completely excised and submitted for histology. This confirmed the diagnosis of an epidermoid cyst lined by keratinizing squamous epithelium. There was no induration, tenderness and sign of recurrence after excision of the mass. Conclusion: Epidermal cyst of the nasal tip region represents an unusual clinical lesion and it presents as foreign body reaction. And then, our case demonstrates that meticulous surgical approach and suture technique are the keys to prevention against iatrogenic nasal epidermoid cyst, especially in secondary rhinoplasty.

Keywords

References

  1. Lee HJ, Choi CH, Kim TH, Myung NS: A case of epidermoid cyst presenting as a preauricular fistula. J Clinical Otolaryngol 18: 241, 2007
  2. Thompson AC, Bradley PJ: Iatrogenic epidermoid cyst of the parotid region following ear surgery. J Laryngol Otol 105: 227, 1991 https://doi.org/10.1017/S0022215100115452
  3. Moon IH, Lee WH, Lee CH, Joo JB, Cho JE, Lee HJ: A clincal study of infected epidermal cysts on ear lobe. J Clinical Otolaryngol 15: 256, 2004
  4. Kim HJ, Burm JS, Pyon JK, Kim YW: Acquired dermoid cysts within subcutaneous scar tissue. J Korean Soc Plast Reconstr Surg 34: 507, 2007
  5. Jung J, Lee BJ, Ahn SK, Song DH, Lee WS, Kim SC: A clinical and histopathologic study of epidermoid cysts. Korean J Dermatol 31: 517, 1993
  6. Di Benedetto G, Pierangeli M, Scalise A, Pauri F, Bertani A: Giantic epidermoid cyst of the skull. Plast Reconstr Surg 97: 1246, 1996 https://doi.org/10.1097/00006534-199605000-00024
  7. Kim ST, Kim DH, Jun JB: A case of traumatic epidermoid cyst. Korean J Dermatol 20: 617, 1982
  8. Kim ES, Cho SH, Yoo SI, Noh BK, Hwang JH, Kim KS, Lee SY, Choi YD: Chondroid syringomas arising on the nasal dorsum and the upper lip: Two cases of report. J Korean Soc Plast Reconstr Surg 34: 503, 2007