In our series of cystic lesions, the combination of thick extracellular material (which in retrospect most likely represented keratinous
debris) and gastrointestinal contamination led to the false impression of mucus-producing cystic neoplasm with an aspirate from a lymphoepithelial cyst.
Of all the oral antifungal agents, this triazole has the broadest in vitro spectrum of activity, which includes activity against dermatophytes, Candida species as well as some moulds.9 It is a highly lipophilic drug with a high affinity for keratinous
tissues, in which the concentration is several times greater than that obtained in plasma.
Possible reported complications associated with gastrointestinal teratomas include adenocarcinoma, (6) ulceration, rupture and bleeding, (4,7) foreign body giant cell reaction secondary to keratinous
contents, (3,4) regional lymphadenopathy, (3) intestinal obstruction, (2) failure to thrive, (8) and anemia.
material was seen in the centre of lobules.
There can be extensive foreign body giant cell reaction to the keratinous
material and dystrophic calcification.
It presents as clustered pits filled with black keratinous
plugs resembling blackheads with inflammatory acne lesions developing later.4 Their size is variable ranging from few centimeters to extensive lesions affecting half of the body.1 The intervening epidermis may appear normal, hyperkeratotic, or slightly hypo- or hyperpigmented.4 Face, trunk and upper extremities are most commonly affected.
pultaceous foul smelling discharge from lump was present.
The cavity showed presence of lamellated type of keratinous
HISTOPATHOLOGICAL REPORT: Section showed stromal tissue with keratinous
shadow cells with no nuclei and are surrounded by mononuclear cell infiltrate predominantly lymphocytes and few plasma cells along with plenty multinucleated giant cells reacting to tumour keratin.
They proposed the following microscopic diagnostic criteria: (a) Nests of cuboidal or polygonal cells; (b) Intercommunicating tubuloalveolar structures lined with two or more rows of cuboidal cells; (c) Ductal structures composed of one or two rows of cuboidal cells; (d) Occasional keratinous
cysts; (e) A matrix of varying composition in hematoxylin and eosin stain.
DISCUSSION: Cutaneous horn or cornu cutaneum are elongated, keratinous
projections from the skin, ranging in size from a few milli meters to many centimetres that resembles a miniature horn.
In 1954, Damste and prakken (1) followed by lowenthal and Prakken in 1961 (2, 4) used the terminology for patients with atrichia with multiple follicular keratinous