FINAL DIAGNOSIS
SKIN, LEFT CHEEK, EXCISION: STEATOCYSTOMA
MICROSCOPIC DESCRIPTION
Low power view shows the lesion to be multicystic (Figure 1). Higher power view shows the cysts are lined by squamous epithelium with a characteristic hyaline cuticle at the surface (Figure 2), and sebaceous glands arising from the cyst wall (Figure 3). These features support the diagnosis of steatocystoma rather than epidermal inclusion cyst. Epidermal inclusion cysts are also lined by epidermis-like epithelium, do not show sebaceous glands, and more typically show keratin debris within the cyst.
This patient presented with a single lesion of the face which was excised. Steatocystoma may also be seen as part of steatocystoma multiplex, an autosomal dominant condition in which patients develop multiple of these cysts on the upper trunk and face (1).
REFERENCE
Contributed by Timothy Gorrill, MD, PhD and Roy Frye, MD, PhD