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All dermoid cysts arising at the cranial vault had been reported as being located subgaleally, i.e. under the galea aponeurotica or epicranium. We are presenting a case that we believe to be the first case of an intragaleal dermoid cyst ever reported. An eighteen years old girl presented at our consultation for a midline frontal swelling evolving since 2 years. Neurological examination was normal. The Computed Tomography (CT) scan showed a round shaped heterogeneous mass at the vertex with no intracranial extension. The lesion was excised surgically. It appeared to be located intragaleally (within the epicranium) and composed of hairs and liquefied fat evocative of a dermoid cyst. The diagnosis of dermoid cyst was confirmed on histology. Postoperative outcome was excellent and the patient is symptom-free 16 months after surgery.
sinuses are a rare entity of spinal dysraphism. Most patients have cutaneous
markers of their presence, including nevus or port wine stains, dimple,
hypertrichosis and subcutaneous lipoma. Inclusion tumors, such as dermoid
tumor, are associated to dermal sinus tract; they are congenital, benign and
slow-growing lesions of midline. Their clinical relevance is due to the
possibility of causing infection, spinal abscess, signs of corde or nerve root
compression. Spinal Magnetic Resonance Imaging (MRI) is the diagnostic tool of
choice. We present the case of a child with atypical meningitis, resistant to
large spectrum antibiotic therapy, caused by an infected dermoid cyst,
undiagnosed in the first months of life despite repeated MRI.