SEBACEOUS CYST
G.Manvitha
Roll no :48
• A 45 year old male patient from villianur who is farmer by occupation
came to the opd with chief complaints of swelling over the back of the
trunk in the midline since 4 years
• CHIEF COMPLAINTS;
Swelling in the back of the trunk in the middle since 4 years
• HISTORY OF PRESENTING ILLNESS:
The patient was apparently normal before 4 years then he developed a
small swelling over the back, which is insidious in onset and progressed to
current size of 3×2cm.
No H/O Discharge,
No H/O Pain,
No H/O fever ,
NO H/O trauma ,
No H/O ulceration & dilated veins,
No H/O weight loss.
• PAST HISTORY:
No similar complaints in the past.
N/K/C/O diabetes mellitus , hypertension ,tuberculosis, bronchial
asthama.
No history of any surgery.
No H/O any blood transfusions.
• FAMILY HISTORY:
No significant family history.
• PERSONAL HISTORY:
He consumes mixed diet, normal apetite.
Normal sleep pattern, normal bowel and bladder habits,
Non-smoker ,Non-alcoholic.
No H/O any drug intake.
No H/O any allergy.
• GENERAL EXAMINATION:
Conscious, moderately built & well nourished, oriented to time and place
No Pallor, Icterus ,Cyanosis, Clubbing , Lymphadenopathy, Edema
• VITALS:
Pulse rate:80bpm Blood pressure: 120/80mmHg
Respiratory rate: 17cycles/min Temperature: Afebrile
• LOCAL EXAMINATION:
INSPECTION: A single oval swelling measuring 3×2cm is present in
the mid line of back approximately 5 cm above the sacral promontory, the
edges of swelling is well defined, skin over the swelling is shiny, a black
colored punctum on its surface, skin surrounding the swelling is normal,
no scars, sinuses and dialated veins,no visible pulsations seen.
• PALPATION: All inspectory findings are confirmed
No warmth, tenderness,
Swelling present in the midline of back approximately 5cm above sacral
promontory,
Movable swelling,
Size of 3×2cm, oval in shape,
Cystic in consistency.
Fistula test positive, fluctuant,transillumination test negative,
The skin is pinchable all over the swelling except at punctum, well defined
edges ,
Surrounding skin is normal.
• SYSTEMIC EXAMINATION:
CVS: S1, S2 heard, no murmur
CNS: No focal neurological deficit
RS: No vesicular breath sounds heard
PA: Soft , non tender , no organomegaly.
• PROVISIONAL DIAGNOSIS:
Benign cystic swelling probably sebaceous cyst in the back without any
complication.
• DIFFERENTIAL DIAGNOSIS:
- Lipoma
- Dermoid cyst
- Neurofibroma
• INVESTIGATIONS:
- Routine blood investigation.
- Hb, TC ,DC.
-Random blood sugar.
• COMPLICATIONS:
-Infection and abscess formation.
-Cock’s peculiar tumour.
-Sebaceous horn.
• TREATMENT:
Excision of the sac and send for biopsy for histopathological
examination.
Elliptical incision
• SURGICAL MANAGEMENT:
Incision and drainage
The incision made is cruciate incision: Remove along capsule of
cyst.
• CONTRAINDICATION:
Bleeding disorder,
Taking anti-coagulant,
Thrombocytopenia.
DISSCUSSION
• Most commonly found in head, neck, trunk and scrotum.
• Usually asymptomatic
• Located in subcutaneous tissue.
• Cyst consistency made of thin white capsule filled with a thick, cheesy
and keratinous material.
• Is a result of obstruction of sebaceous gland duct.
• They are usually mobile, slow growing ,round shaped, painless,
• These keratin- containing lesions are usually seen in young and middle-
aged adults in relation to a pilosebaceous follicle.
• Long standing goes for infection.
• Physical examination fluctuation, tender
THANK YOU
