A Case of Steatocystoma Simplex Involving the Scalp: DISCUSSION

Steatocystoma simplex is thought to originate from a nevoid malformation of the pilosebaceous duct junction and a non-heritable benign adnexal tumor. Brownstein first reported 30 cases of stea- tocystoma simplex as distinct clinical entity compared with steatocystoma multiplex as a counterpart disease in 1982.

The individual lesion of steatocystoma simplex is identical with that of steatocystoma multiplex clinically and histologically. The lesion of steatocystoma is usually asymptomatic, with a normal skin color and no inflammatory component. Steato- cystoma simplex is a soft, movable intracutaneous cyst with a distinct boundary. To distinguish important to make sure that the lesion is solitary and occurs in adulthood with a non-heritable pattern. Steatocystoma simplex can occur on various parts of the body, but most commonly on the face and the chest. The upper limbs and axillae are also relatively common sites of occurrence. Rarely, steatocystoma simplex can occur on relatively uncommon sites, such as the back, leg, oral cavity, perineum, and scalp. Four cases of steatocytoma simplx have been reported and only one case has been reported to involve the scalp in the Korean medical literature (Table 1). Steatocytoma simplx involving the scalp is extremely rare and only two cases have been reported in foreign medical journals by Brownstein1 and Nakamura et al . This case report on steatocystoma simplex occurring on an uncommon site, the scalp, is considered to be a very rare medical case.
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Table 1. The reported cases of steatocystoma simplex in the Korean medical literature

Korean medical literature

No.

Author

Sex/ c Site

Age

Duration Treatment

1

Lee et al3

M/63 Scalp

1 year

None

2

Kim et al4

M/42 Left

Several

Excision


Kim et al7

caruncle

years


3

F/52 Nose

3 months

Excision

4

Kim and

F/22 Left orbit Several

Excision


Ahn8


years


5

Present

M/49 Scalp

1 year

Excision


case




On gross examination, the cyst contained oily, yellowish fluid. The histological examination revealed a cystic mass surrounded by stratified squamous epithelium with a saw-tooth appearance that lacked a stratum granulosum. In the innermost area of the cyst, a prominent, acellular, homo-genous, eosinophilic, and compact horny layer was seen. Large, flattened sebaceous glands were within or near the cyst wall. If there is a hyaline cuticle in the cystic wall, it can be shown to be a steatocystoma simplex, even in the absence of sebaceous glands.

The differential diagnosis of steatocystoma simplex includes steatocystoma multiplex, a dermoid cyst, cystic sebaceous hyperplasia, and hidrocystoma. Steatocystoma multiplex is differentiated by multiple lesions, usually over the trunk, and inherited in an autosomal dominant pattern. A dermoid cyst, cystic sebaceous hyperplasia, and hidrocystoma are distinguished by histologic characteristics.
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Above all, the treatment of choice is simple excision with an intact cyst wall to reduce the risk of recurrence. Also, aspiration, cryosurgery, electrocautery, and carbon dioxide laser therapy are included as possible treatment options of steato cystoma simplex. There have been no reported case of recurrent steatocystoma simplex after excision .

Category: Health

Tags: Scalp, Steatocystoma simplex

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