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Musculoskeletal
Diagnosis
Non-Trauma
Soft Tissue Tumors
Skin and Subcutaneous Lesions
Epidermoid/Epidermal Inclusion Cyst
Epidermoid/Epidermal Inclusion Cyst
Stephanie A. Bernard, MD; Catherine C. Roberts, MD; Kirkland W. Davis, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Epidermal cyst (EC), epidermoid cyst, infundibular cyst, epidermal inclusion cyst (EIC)
                • EIC: Subset of EC from deep implantation of squamous epithelium often from injury (including iatrogenic)

            • Definitions

              • Common benign lesion of cutis and subcutis that arises from obstruction of hair follicle (EC) or ectopic implantation of epidermis (EIC)

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Hoang VT et al: Overview of epidermoid cyst. Eur J Radiol Open. 6:291-301, 2019
                                          2. Clarke R et al: Twinkle artefact in the ultrasound diagnosis of superficial epidermoid cysts. Ultrasound. 24(3):147-53, 2016
                                          3. Feng CJ et al: Treatment of epidermal cysts with erbium: YAG laser fenestration: an alternative to surgical intervention. Ann Plast Surg. 74 Suppl 2:S89-92, 2015
                                          4. Melamud K et al: Diagnostic imaging of benign and malignant osseous tumors of the fingers. Radiographics. 34(7):1954-67, 2014
                                          5. Hwang DY et al: Multiple huge epidermal inclusion cysts mistaken as neurofibromatosis. J Craniofac Surg. 19(6):1683-6, 2008
                                          6. Takemura N et al: Fluid-fluid level in a giant epidermal cyst of the buttock. J Dermatol. 34(3):193-7, 2007
                                          7. Golshan Momeni M et al: Giant epidermal inclusion cyst of buttock. Skeletal Radiol. 35(11):864-6, 2006
                                          8. Kransdorf MJ et al: Masses that may mimic soft tissue tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 2nd ed. Lippincott Williams & Wilkins. 560-1, 2006
                                          9. Patel K et al: Epidermal inclusion cyst of phalanx: a case report and review of the literature. Skeletal Radiol. 35(11):861-3, 2006
                                          10. Shibata T et al: Magnetic resonance imaging features of epidermoid cyst in the extremities. Arch Orthop Trauma Surg. 123(5):239-41, 2003
                                          11. Baredes S et al: Radiology quiz case. Epidermal inclusion cyst with intracystic keratin debris. Arch Otolaryngol Head Neck Surg. 128(6):723-4, 2002
                                          12. Fisher AR et al: Ruptured plantar epidermal inclusion cyst. AJR Am J Roentgenol. 171(6):1709-10, 1998
                                          13. Fujimoto H et al: Large epidermal cyst involving the ischiorectal fossa: MR demonstration. Clin Imaging. 17(2):146-8, 1993
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Epidermal cyst (EC), epidermoid cyst, infundibular cyst, epidermal inclusion cyst (EIC)
                                                        • EIC: Subset of EC from deep implantation of squamous epithelium often from injury (including iatrogenic)

                                                    • Definitions

                                                      • Common benign lesion of cutis and subcutis that arises from obstruction of hair follicle (EC) or ectopic implantation of epidermis (EIC)

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Hoang VT et al: Overview of epidermoid cyst. Eur J Radiol Open. 6:291-301, 2019
                                                                                  2. Clarke R et al: Twinkle artefact in the ultrasound diagnosis of superficial epidermoid cysts. Ultrasound. 24(3):147-53, 2016
                                                                                  3. Feng CJ et al: Treatment of epidermal cysts with erbium: YAG laser fenestration: an alternative to surgical intervention. Ann Plast Surg. 74 Suppl 2:S89-92, 2015
                                                                                  4. Melamud K et al: Diagnostic imaging of benign and malignant osseous tumors of the fingers. Radiographics. 34(7):1954-67, 2014
                                                                                  5. Hwang DY et al: Multiple huge epidermal inclusion cysts mistaken as neurofibromatosis. J Craniofac Surg. 19(6):1683-6, 2008
                                                                                  6. Takemura N et al: Fluid-fluid level in a giant epidermal cyst of the buttock. J Dermatol. 34(3):193-7, 2007
                                                                                  7. Golshan Momeni M et al: Giant epidermal inclusion cyst of buttock. Skeletal Radiol. 35(11):864-6, 2006
                                                                                  8. Kransdorf MJ et al: Masses that may mimic soft tissue tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 2nd ed. Lippincott Williams & Wilkins. 560-1, 2006
                                                                                  9. Patel K et al: Epidermal inclusion cyst of phalanx: a case report and review of the literature. Skeletal Radiol. 35(11):861-3, 2006
                                                                                  10. Shibata T et al: Magnetic resonance imaging features of epidermoid cyst in the extremities. Arch Orthop Trauma Surg. 123(5):239-41, 2003
                                                                                  11. Baredes S et al: Radiology quiz case. Epidermal inclusion cyst with intracystic keratin debris. Arch Otolaryngol Head Neck Surg. 128(6):723-4, 2002
                                                                                  12. Fisher AR et al: Ruptured plantar epidermal inclusion cyst. AJR Am J Roentgenol. 171(6):1709-10, 1998
                                                                                  13. Fujimoto H et al: Large epidermal cyst involving the ischiorectal fossa: MR demonstration. Clin Imaging. 17(2):146-8, 1993