The presence of a nasal midline dermoid (teratoid) cyst may be an indication of neural tube dysraphism.
The dermoid cyst may contain mesodermal and ectodermal elements (skin, fat, muscle, cartilage, bone, minor salivary glands, neural tissue, lymphoid tissue)
Location: anywhere from the glabella to the nasal tip
Features: often subcutaneous and often presenting as a firm bluish nodule
The patient may present with apparent hypertelorism if the cyst is at the glabella.
Associated lesion: dermal sinus or pit that may extend to the cyst. These should not be probed.
In a significant percentage of case the cyst may connect with the central nervous system. If there is a connection and if there is a connected dermal sinus then:
(1) CSF may drain from the sinus
(2) the patient may have recurrent meningitis
Related lesions in cases of neural tube dysraphism may include:
(1) nasal glioma
(2) frontal encephalocele
