Epidermoid cysts are slow-growing, painless masses that elevate the skin and often have a central punctum that represents the plugged orifice of the pilosebaceous follicle. On ultrasound, they have a round to oval structure, well-circumscribed, avascular mass located in subcutaneous tissue along with phenomena of dorsal acoustic amplification and lateral shadowing. On MRI, they have slightly hypointense signal intensity on T1-weighted and intermediate to high signal on T2-weighted. Restricted diffusion is typical of epidermoid cysts. These signs are useful in the differentiation of epidermal cysts from neoplastic lesions. They need early treatment as they can cause cosmetic and functional impairment.
Keywords: ADC, apparent diffusion coefficient; CT, computed tomography scan; Cutaneous cyst; DWI, diffusion weighted images; Epidermal; Epidermoid; Keratin; MRI, magnetic resonance images; PDW, proton-density weighted; Sebaceous; Skin lesion; T1W, T1-weighted; T2W, T2-weighted.