Presacral tumours are considered very rare tumours with their incidence being around 1:40 000. Presacral dermoid tumours, part of the family of presacral tumours, usually present in the female adult population. They are benign tumours arising from all the three germ cell layers. Presentation in a paediatric population, defined as an individual under the age of 18 years, is extremely rare. A 15-year-old girl presented with abdominal pain present for 5 years diagnosed as a somatisation disorder. Upon further investigation with abdominal CT and MRI a diagnosis of a presacral mass was made. A laparoscopic-assisted transabdominal excision of the mass was performed and histopathology confirmed the radiological suspicion of a presacral dermoid cyst. As there are no reports of a presacral dermoid cysts being excised and reported in the paediatric surgical literature, we hope to highlight this pathology as a potential cause of abdominal pain in the paediatric population.

Uncommonly, Klippel-Feil syndrome (KFS) has been associated with intracranial or spinal tumors, most frequently dermoid or epidermoid cysts. Although the associated dermoid cyst (DC) is usually located in the posterior fossa, isolated upper cervical DC has been reported. Extension from the posterior fossa to the upper cervical spine (C2) has been reported once. We report a rare case of KFS in association with a posterior fossa DC that extended down to the upper thoracic spine and review the current literature.A 47-year-old female with presented cervical myelopathy related to a cranio-cervico-thoracic DC in association with KPS-related cervicothoracic fusion (C2-T6) and thoracic kyphosis. The patient underwent complete tumor resection following sub-occipital craniectomy and C1-C4 cervical laminectomy. The patient exhibited complete resolution of symptoms with no tumor recurrence and no deformity at 6-year follow-up.DC should be added to the list of congenital central nervous system abnormalities, which should be sought in patients with KFS. Therefore, the presence of a cystic lesion in the posterior fossa, the craniocervical junction or the anterior cervical spine should suggest the possibility of a DC in patients with KFS. In cases of cranio-cervical DC, the tumor may extend quite far down the spinal column (reaching the thoracic spine), as demonstrated in the present case.

Intracranial dermoid cysts are rare congenital lesions that typically occur in the cisternal spaces. However, exceptionally rare cases of intraaxial involvement have been reported, with only 8 cases having been described in the literature. The authors report the first case of an intraaxial dermoid cyst located in the medulla and the first occurrence in an elderly patient. They also review the literature of the existing intraparenchymal cases and provide treatment guidelines. A 66-year-old man presented with slowly progressive dysphagia, left lower-extremity numbness, nausea, and hyperhidrosis. Neurological examination revealed decreased pinprick sensation of the left side of his face and body, and decreased vibratory sensation in his left lower extremity. Additionally, he had an unusual extraocular movement in which abduction of the eye resulted in closure of the contralateral eye. Magnetic resonance imaging revealed a nonenhancing cystic lesion centered in the medulla. The patient underwent a suboccipital craniotomy with laminectomy of C1-2 for excision of the cyst, with subtotal resection due to adherence of the cyst wall to the brainstem. At follow-up 7.5 years after surgery, the patient's neurological examination was stable. Magnetic resonance imaging did not reveal any progression or recurrence of the cyst. As the cyst wall is typically adherent to surrounding structures, resection is usually subtotal due to the risk of neurological deficits. As there have been no cases of progression after subtotal resection, gross-total resection is not warranted for the treatment of these lesions.

A 56-year-old woman presented with a cystic skull lesion in the right temporal bone detected after resection of breast cancer. She underwent resection of the skull tumor for pathological diagnosis and treatment. The tumor was covered with ciliated epithelium and there were no malignant findings. The pathological diagnosis was ciliated epithelial inclusion cyst. Intradiploic inclusion cysts of the skull presenting as a calvarial defect include epidermoid cysts and dermoid cysts, which are clinically difficult to differentiate. Ciliated epithelium lining an intradiploic inclusion cyst is very rare. Surgical resection is essential for a definitive diagnosis and differentiation from a neoplasm.

To analyze the pathological classification of ocular tumor in children.213 cases (214 eyes) of ocular tumor in children below 14 years old between January 2001 and December 2007 in Henan Eye Institute were reviewed retrospectively, the pathological classification were made according to the location and nature of the tumor.There were 17 eyes (7.94%) of 214 eyes with benign tumor of eyelid, the leading two tumor were 4 eyes with cyst, in which 1 eye with epidermoid cyst and 3 eyes with dermoid cyst were included, and 3 eyes with squamous papilloma. There were 84 eyes (39.25%) of 214 eyes with conjunctival and corneal tumor, 1 eye with intraepithelial tumor was found, other tumors were all benign tumor, the leading three tumors were corneal dermoid (64 eyes), conjunctival nevus (10 eyes) and suamous papilloma (4 eyes). There were 73 eyes (34.11%) with intraocular tumor including 66 eyes (90.41%) with retinoblastoma, 6 eyes (8.22%) with iris cyst and 1 eye (1.37%) with iris melanoma. Of 38 eyes of orbital tumor, cyst (16 eyes), vascular hamartoma (7 eyes) and inflammatory pseudotumor (4 eyes) were the most common benign tumors, there were 3 eyes (7.89%) with orbital extention of retinoblastoma and 2 eyes (5.26%) with rhabdosarcoma. There were 2 eyes with scleral tumor, including 1 eye with scleral bony choristoma and 1 eye with congenital scleral cyst. Altogether, there are 135 eyes (63.08%) with benign tumor and 79 eyes (36.92%) with malignant tumors.Most children's ocular tumors are congenital and embryonic tumors. Retinoblastoma is the most common malignant ocular tumor in children, then is corneal dermoid.

The existence of a benign form of postpubertal testicular teratoma, apart from the rare dermoid cyst, is not widely recognized. This study reports 25 apparently benign postpubertal testicular teratomas, including 10 cases of dermoid cyst and 15 of nondermoid teratomas, which occurred in 25 patients, 12 to 59 years of age (mean, 24 y). Postpubertal status was based on active spermatogenesis in the testis. On gross examination 15 of 16 tumors with available information had a variably prominent cystic component filled with keratinous or mucoid material. On microscopic examination, the 10 dermoid cysts were lined by keratinizing, stratified squamous epithelium with associated pilosebaceous units and sweat glands in an organoid arrangement. Squamous cysts also occurred in 10 of 15 nondermoid teratomas, which by definition lacked adnexal structures. Apart from 2 dermoid cysts additional elements occurred in all cases, most commonly ciliated or respiratory-type epithelium (64%) and smooth muscle (68%). Organoid arrangements were also present in 5 of the nondermoid teratomas. No case showed cytologic atypia nor did the parenchyma adjacent to the teratomas of either type show intratubular germ cell neoplasia, unclassified type, microlithiasis, scarred zones, or more than focal perilesional tubular atrophy/sclerosis. Spermatogenesis was intact in all cases. FISH study for chromosome 12p was performed in 18 cases, and none displayed an abnormal 12p chromosome. All 17 patients that had follow-up information were alive at postoperative intervals of 5 to 168 months, although physician-confirmed disease-free status was unfortunately not available in 6 of these. This study supports the recognition and separate classification of not only dermoid cysts but also a small subset of apparently benign testicular teratomas in postpubertal patients that share many features with dermoid cysts but lack cutaneous-type adnexal structures. Features important in the recognition of both forms of these specialized teratomas of the postpubertal testis include absence of all of the following: cytologic atypia, intratubular germ cell neoplasia, unclassified type, significant tubular atrophy/tubular sclerosis, scarred zones, impaired spermatogenesis, microlithiasis, and evidence of chromosome 12p amplification. Other features include frequent organoid morphology and prominent components of ciliated epithelium and smooth muscle. It is important to distinguish these teratomas from the usual ones seen in postpuberal patients because of the malignant potential of the latter.

Intraspinal dermoid cysts are rare and benign tumors that occur primarily due to the defective closure of the neural tube, an ectodermal derivative, during the process of development. They are slow-growing tumors manifesting in the second and third decades of life.We present here a case of a 14-year-old Sindhi boy with a six-month history of paraparesis of the lower limbs and a progressive loss of power of grade 3/5, and hypoesthesia in the L4/L5 dermatomes of his right lower limb. A plain magnetic resonance imaging scan revealed a well-demarcated intraspinal intramedullary cyst containing an abscess at the level of T12 and L1 causing localized cord compression, which was producing the symptoms. Near total excision of the cyst was successfully performed and was sent for biopsy, which revealed keratinocytes and keratin flakes. With one month of follow-up, along with physiotherapeutic management, the patient gradually improved and was able to walk without support.Critical evaluation of every case with aggravating symptoms should be carried out, and neurological and radiological examinations should be conducted to ensure the well-being of patients.