Edorium Journal of

Radiology

 
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Case Report
 
A giant pelvic epidermoid cyst with malignant transformation to squamous cell carcinoma
Ryo Fujita1, Shigeo Takebayashi2, Zenjiro Sekikawa3, Izumi Torimoto4
1MD, Attending Physician, Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan.
2MD, Chief and Professor, Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan.
3MD, Assistant Professor, Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan.
4MS, Postgraduate Student, Radiology.Yokohama City University Graduate School of Medicine, Yokohama, Japan.

Article ID: 100001R02RF2015
doi:10.5348/R02-2015-1-CR-1

Address correspondence to:
Shigeo Takebayashi
MD, Department of Diagnostic Radiology, Yokohama City University Medical Center
4-57, Urafune-cho, Minami-ku, Yokohama
Japan 232-0024
Phone: 001-81-45-261-5656
Fax: 001-81-45-253-5726

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How to cite this article
Fujita R, Takebayashi S, Sekikawa Z, Torimoto I. A giant pelvic epidermoid cyst with malignant transformation to squamous cell carcinoma. Edorium J Radiol 2015;1:1–5.


Abstract
Introduction: We report a rare case of pelvic epidermoid cyst with malignant transformation to squamous cell carcinoma.
Case Report: A 48-year-old male who had difficulties of both urination and defecation. Multidetector computed tomography (MDCT) revealed a 12-cm cystic mass with a contrast enhanced mural tumor in the presacral area extending to the left ischioanal space. Magnetic resonance imaging (MRI) scan showed that the mural tumor with gadolinium-diethlene triamine penta acetic acid (Gd-DTPA) contrast enhancement extended both the interior and over the wall of the cystic mass. A hypermetabolic activity with 10.7 of maximum standardized uptake value (SUV max) was limited to the mural tumor in the left anterior superior wall of the mass, but no increased activity in other portion of the wall. Unknown origin malignant cell was obtained percutaneous core biopsy under ultrasound guidance. Anaplastic malignant cell carcinoma was made on a core needle biopsy on surgical exploration after percutaneous core biopsy under ultrasound guidance demonstrating unknown origin malignant cell. The patient underwent four courses of chemotherapy using paclitaxel. Follow-up FDG-PET/CT demonstrated decreased SUV max of the mural tumor was 3.7 that is greater than normal upper limit. Subsequently, the resection of both the tumor and the rectum were performed. Pathological examination demonstrated squamous cell carcinoma in the epidermoid cyst.
Conclusion: A pelvic epidermoid cyst with malignant transformation to must be considered in the differential diagnosis of a pelvic cystic tumor although it is extremely rare.

Keywords: Epidermoid cyst, Pelvic cyst, Presacral cyst, Squamous cell carcinoma


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Author Contributions
Ryo Fujita – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Shigeo Takebayashi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Zenjiro Sekikawa – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Izumi Torimoto – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Ryo Fujita et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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