Primary dermoid cysts of the cecum: A systematic review and case report.

rationaleCecal dermoid cysts, mature cystic teratomas, are exceedingly rare. They may present with nonspecific abdominal pain and mimic common surgical conditions. We report a pediatric case of cecal dermoid cyst presenting with acute appendicitis and provide a systematic review of all published cecal dermoid cases. PATIENT CONCERNS: A 14-year-old female presented with 1 day of right lower abdominal pain, nausea, vomiting and anorexia; she had prior vague right-sided pain with an ultrasound 5 years earlier that identified a right iliac fossa cyst, which was not followed up. DIAGNOSES: Contrast-enhanced computed tomography showed an inflamed appendix with peri-appendiceal fat stranding and an appendicolith, and a separate well-defined hypodense lesion (3.5 × 3.2 cm) at the ileocecal junction. Differential diagnoses included duplication cyst, dermoid cyst, or low-grade mucinous neoplasm.

interventionsDiagnostic laparoscopy confirmed acute appendicitis and a distinct cecal mass with enlarged ileocolic lymph nodes. Because malignancy could not be excluded intraoperatively, a laparoscopic oncologic right hemicolectomy with ileocolic anastomosis was performed. OUTCOMES: Histopathology demonstrated a benign dermoid cyst and acute suppurative appendicitis with microscopic perforation; 20 reactive lymph nodes were negative. The postoperative course was uneventful and the patient was discharged. LESSONS: Cecal dermoid cysts are rare and can mimic common pathologies such as appendicitis or ovarian masses. Preoperative diagnosis is challenging; definitive diagnosis requires surgical excision and histopathology. Laparoscopy is a useful diagnostic and therapeutic tool, but oncologic resection may be required when malignancy cannot be excluded intraoperatively.