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Cranial lateral dermal sinus tract: illustrative case.

Joshua M Cohen1, Hailey D Reisert1, Elizabeth Cohen1

  • 1Albert Einstein College of Medicine and.

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Lateral cranial dermal sinus tracts (DSTs) are rare congenital anomalies. This case highlights the importance of considering atypical locations for DSTs and prompt surgical excision to prevent complications.

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Area of Science:

  • Neurology
  • Pediatric Surgery
  • Developmental Biology

Background:

  • Dermal sinus tracts (DSTs) are rare congenital anomalies from incomplete neural tube closure.
  • While spinal DSTs are common, cranial DSTs are less frequent, typically midline.
  • Lateral cranial DSTs, particularly temporal bone involvement, are exceptionally rare and lack clear embryological explanation.

Purpose of the Study:

  • To review the literature on lateral cranial dermal sinus tracts.
  • To present an exemplary case of a lateral cranial DST.
  • To emphasize the clinical significance and management of these rare anomalies.

Main Methods:

  • A scoping review identified 19 publications detailing 23 unique cases of lateral cranial DSTs.
  • An exemplary case involved a 20-month-old female with a congenital temporal dimple.
  • Diagnostic imaging (MRI) and surgical excision (craniotomy) were employed.

Main Results:

  • The exemplary case presented with a deep DST to the bone, asymptomatic apart from one fluid drainage episode.
  • Surgical excision successfully removed the tract and an associated dermoid cyst without complications.
  • Follow-up imaging at 5 months showed no recurrence.

Conclusions:

  • Lateral cranial DSTs are rare, and this case adds to the limited existing literature.
  • Benign dermoid cysts within DSTs can enlarge and threaten neurovascular structures.
  • Early surgical excision is critical for managing lateral cranial DSTs, even in asymptomatic cases.