“Sack of marbles” growing on Bengaluru woman’s scalp removed; know what it means – Times of India
“At examination, there was a 15 × 10 × 12–cm mass in the parieto-occipital region.
MRI scan showed a large cystic lesion in the subgaleal plane of the scalp. It was hypointense with T1-weighted images and hyperintense with T2-weighted images and contained multiple nodules of varying sizes floating in the cyst, giving it a “sack of marbles” appearance,” the report says.Post-surgery, sebum-like material, hard spherules, and multiple strands of hair was found in the cyst.
“There was no recurrence after 6 months of follow-up,” the report says.
The “sack of marbles” is a sign of mature cystic teratomas, which are mostly found in the head and neck region. The marble-like appearance is due to the spherical aggregates of keratin, fat, sebaceous material, fibrin, and hair floating within the fluid matrix of the cyst.
Doctors at the Sri Sathya Sai Institute of Higher Medical Sciences who identified the cyst through an MRI scan have said this to be an uncommon case.
What is mature cystic teratomas?
Mature cystic teratomas is a benign tumor which is also called dermoid cyst. Research reports say it has a slow growth rate of 1.8 mm/ year and is rarely malignant. According to a 2020 study published in Oral and Maxillofacial Surgery Cases journal, the incidence of teratomas of the head and neck ranges from 1:20,000 to 1:40,000 births. The study highlights another such case where an ultrasound prenatal screening of a 25-year-old woman at 23 weeks of gestation found a large cystic mass in the upper left cervical region of the fetus. “At palpation, the mass was soft, painless, well circumscribed, measuring approximately 5 × 6 × 7 cm. There was no discoloration of the overlying skin. Ultrasonographic imaging and Magnetic Resonance Imaging (MRI) revealed a well-defined, homogeneous, thin walled, posterior cystic mass occupying the upper left cervical and the retro auricular region,” the study found.
The tumor was removed successfully when the child was three months old.
As per reports, the first case of cystic teratoma was reported by Johannes Scultetus in 1659 when he was recording the autopsy reports of a young woman who died of an ovarian tumor and described it as a “dermoid cyst of the ovary.”
Experts say these cysts do not cause any symptoms and only timely medical screening can help detect it sooner. Doctors aim to remove it after ascertaining its nature and the risk of potential damage it can do to other body organs.
