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 Dr Sampurna Roy MD

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Cutaneous ciliated cyst is an exceedingly rare, benign lesion.

These are most commonly found in the dermis or subcutis of the lower extremities of young female patients in their second and third decades.

The cysts are usually less than 3cm in diameter.

These cysts are lined by ciliated cuboidal to columnar epithelium with pseudostratified areas.

The pathogenesis of the cyst is unknown.

The histologic, immunohistochemical, and ultrastructural findings of  some cases and the literature provide evidence in favour of the Mullerian heterotopia theory.   Images

Evidence in favour of Mullerian origin   include the strong association with the female gender, location on lower limbs, frequent growth during reproductive years, and the Estrogen Receptor (ER) and Progesterone Receptor (PR) positivity.

The differential diagnosis of cutaneous ciliated cyst  includes other cutaneous cysts capable of showing cilia, namely, bronchogenic cyst, branchial cleft cyst, thymic cyst, thyroglossal duct cyst, vulvar cyst, perianal (caudal gut) cyst, and cutaneous endosalpingiosis.

A 16-year-old girl was seen for a painless subcutaneous mass of 1 year's duration. On excisional biopsy, a collapsed cystic structure lined by stratified, ciliated, columnar epithelium was noted; findings were consistent with cutaneous ciliated cyst. Immunohistochemical staining for progesterone receptor and epithelial membrane antigen were positive, whereas it was negative for carcinoembryonic antigen, which supports the theory of heteropia of the ciliated epithelium from the Müllerian epithelium in its histopathogenesis.

Cutaneous ciliated cyst in the subcutaneous area.Indian J Pathol Microbiol. 2011 Jan-Mar;54(1):150-1.

Biopsy of a 5 mm cystic lesion on the right heel of a 48-year-old woman.Dermatol Online J. 2011 Jun 15;17(6):6

Cutaneous ciliated cyst: a case report with focus on mullerian heterotopia and comparison with eccrine sweat glands. Am J Dermatopathol. 2010 Oct;32(7):731-4.

Cutaneous ciliated cyst of the inguinal area in a man.J Dermatol. 2006 Feb;33(2):146-9.

Cutaneous ciliated cyst of the abdominal wall: a case report with a review of the literature and discussion of pathogenesis.Am J Dermatopathol. 2002 Feb;24(1):63-6.

Cutaneous ciliated cyst: a case report with immunohistochemical evidence for dynein in ciliated cells. Am J Dermatopathol. 2000 Dec;22(6):519-23.

Cutaneous ciliated cyst of the scalp. A case report with immunohistochemical evidence for estrogen and progesterone receptors.Am J Dermatopathol. 1994 Feb;16(1):76-9.

Cutaneous ciliated cyst: case report and literature review.Plast Reconstr Surg. 1990 Aug;86(2):344-6.

Cutaneous ciliated cysts.Arch Dermatol. 1978 Jan;114(1):70-3.

Cutaneous ciliated cyst on the leg in a woman of menopausal age. Acta Derm Venereol. 2009;89:323-4.