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Epidermoid Cyst in an Infected Olecranon Bursa
Andrew Brash1, Kevin Dunham1, Ronit Wollstein1
1Department of Orthopedic Surgery, New York University School of Medicine, New York, New York, United States.
Insights
This case study highlights a rare instance of an epidermoid cyst mimicking septic olecranon bursitis. Early diagnosis is crucial for complete surgical removal of these benign follicular cysts.
Area of Science:
- Dermatology
- Pathology
- Orthopedic Surgery
Background:
- Epidermoid cysts originate from follicular epithelium implantation into the dermis.
- While typically benign and painless, they can cause inflammation or abscesses if ruptured.
- Septic olecranon bursitis is an infection of the elbow's fluid sac.
Observation:
- A 59-year-old woman presented with symptoms suggestive of septic olecranon bursitis.
- A history of remote elbow trauma was noted.
- Histology after incision and drainage revealed a concomitant epidermoid cyst.
Findings:
- The epidermoid cyst was not preoperatively diagnosed due to rare presentation and imaging limitations.
- Incomplete enucleation occurred because the diagnosis was made post-surgically.
- The cyst mimicked the clinical presentation of septic olecranon bursitis.
Implications:
- This case underscores the importance of considering epidermoid cysts in differential diagnoses for elbow masses.
- Improved preoperative imaging may aid in identifying such cysts.
- Complete surgical excision is necessary for definitive treatment of epidermoid cysts.
Abstract:
Epidermoid cysts are common, benign cysts that form due to follicular epithelium implanting into the dermis. Although these cysts are often painless, they can incite an inflammatory process as well as abscess formation, especially if ruptured. Our case involves a 59-year-old woman with a history of remote elbow trauma diagnosed with septic olecranon bursitis with concomitant epidermoid cyst found on histology following incision and drainage (I&D). Due to the rare presentation and inadequate preoperative imaging, the diagnosis of epidermoid cyst was not made prior to surgery, resulting in incomplete enucleation.
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