title: Presternal dermoid cyst mimicking lymphatic malformation: a case report and review of the literature.
abstract: We describe an 11-month-old boy with an unusually large presternal mass present since birth. The large size, fluctuant properties, transillumination, compressibility, and imaging of this lesion were characteristic of a lymphatic malformation. Although four treatments with sclerotherapy markedly reduced its size, it was not until definitive treatment with surgical excision and the final pathology report that we arrived at the ultimate diagnosis of dermoid cyst. Dermoid cysts, although appearing along embryologic lines of closure, are rarely presternal. They are usually small, thick walled, and filled with sebaceous or keratinous fluid, which typically allows for clinical diagnosis, and show characteristic features on magnetic resonance imaging (MRI) and ultrasound. However, this case illustrates that dermoid cysts can appear in somewhat atypical locations, and imaging is not always diagnostic, so dermoid cyst should remain a part of the differential diagnosis for any lesion presenting midsternally, regardless of the size and imaging characteristics.
authors.affiliation: School of Medicine, University of New Mexico, Albuquerque, New Mexico 87131, USA.
authors.forename: Tammy
authors.initials: T
authors.lastname: Berry
authors.forename: Anil
authors.initials: A
authors.lastname: Shetty
authors.forename: Adam
authors.initials: A
authors.lastname: Delu
authors.forename: Marc
authors.initials: M
authors.lastname: Barry
authors.forename: Ryan
authors.initials: R
authors.lastname: Berry
authors.forename: Aimee C
authors.initials: AC
authors.lastname: Smidt
mesh_terms: D001707:Biopsy, Needle; D003884:Dermoid Cyst / Q000151:congenital / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D044148:Lymphatic Abnormalities / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D018570:Risk Assessment; D015911:Sclerotherapy / Q000379:methods*; D012878:Skin Neoplasms / Q000151:congenital / Q000175:diagnosis* / Q000188:drug therapy; D013249:Sternum; D035441:Thoracic Wall / Q000473:pathology; D016896:Treatment Outcome