Objective: Dermoid cysts are developmental malformations originating from ectoderm and mesoderm. They are congenital and usually localized in the head and neck region. Their walls are covered with squamous epithelium and may contain different skin patches and tissues (multiple sebaceous glands, hair follicles, sweat glands, fat, nail, eye, teeth, cartilage). The purpose of this study was to present an approach to the masses in the head and neck region, to evaluate the relationship between preoperative imaging, final pathology and differential diagnosis, and to discuss how treatment planning should be done.

Methods: In this study, 37 patients, who admitted to our clinic for masses in the head and neck region and who underwent surgery after necessary consultations and preoperative evaluation between January 2010 and July 2017 were retrospectively reviewed. Patients were evaluated in terms of age, gender, lesion size, lesion location, preoperative imaging, intracranial involvement, treatment and complications.

Results: Of the 29 patients included in this study, 15 were male (51.7%) and 14 were female (48.2%). The age of the patients ranged from 1 to 28 years and the mean age was 10 years. Twenty-two of the lesions were localized on the lateral side of the eyebrows (75.8%), two on the glabella (6.8%), two in the temporal region (6.8%), one in the occipital region (3.4%), one on the forehead (3.4%), and one in the medial canthal region (3.4%). At the time of admission, all patients complained of swelling under the skin at the localization of the lesion. At least one imaging modality, primarily computed tomography, was requested to assess intracranial involvement in all patients’ preoperatively. The main reason for the removal of lesions was cosmetic problems.

Conclusion: Dermoid cysts are operated not only for the removal of poor cosmetic appearance, but also for the prevention of possible leakage and infection, for definite pathologic diagnosis and for prevention of secondary bone changes.