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Pterional dermal sinus: case report and review of the literature
Lucio Giustiniano1, Yamila Basilotta2, Guido Gromadzyn1
1Hospital de Pediatría J.P. Garrahan, Department of Neurosurgery, Buenos Aires, Argentina.
Introduction:
Dermal sinus (DS) is a congenital condition of embryonic origin that occurs when the surface ectoderm fails to fully separate from the neuroectoderm, despite the neural tube remaining intact. Its most common location is the spinal region, followed by the occipital region. Off-midline presentation is extremely rare. The aim of this study is to present an atypical case of a dermal sinus located in the pterional region, outside the midline.
Case Description:
A 4-year-old male patient presented with a mass in the tail region of the left eyebrow. Contrast-enhanced computed tomography revealed a dermoid cyst associated with a dermal sinus in the pterional region. Physical examination showed a skin dimple in the affected area. Complete surgical excision of the lesion was performed.
Discussion:
Between January 2014 and March 2025, 23 cases of cranial dermal sinuses were diagnosed at our institution. The case presented is the only one with an off-midline location. According to the literature, only 21 pediatric cases of cranial dermal sinuses in the frontotemporal region have been reported since the 1970s. Due to the low prevalence of this location, there is no standardized surgical protocol. However, surgical treatment is unanimously recommended, as it allows for definitive resolution and prevents potential infectious or neurological complications.
Conclusion:
Lateral localization of cranial dermal sinuses is extremely rare. Surgical treatment plays a fundamental therapeutic and preventive role in avoiding complications.
