Jubilee Hospital, Trivandrum.

Dermoid cysts are congenital anomalies that arise from trapped pouches of the ectoderm near the normal fold or from the surface ectoderm that has failed to separate from the neural tube. The dermoid cysts take their origin from primordial germ cell.

Patients with postauricular dermoid cysts usually seek medical advice for the cosmetic reasons because of the embarrassing look of the prominent unilateral or bilateral ears.

A 5-year-old boy presented with a prominent swelling behind the right ear for the last 3-4 years. Swelling was initially small and increased gradually to the present size. Swelling was soft, cystic, globular and non-tender with restricted mobility. Margins are well defined. Skin over the swelling was normal and was not attached to it. There was no discharging sinus or pointing abscess. Bruit or any pulsation was not present in the swelling. There was no history of trauma, fever, loss of appetite, discharging ear, difficulty in hearing etc. The patient had no other complaints or other constitutional symptoms. There was no history of such lesion in his family members.

The cyst was excised under general anesthesia. The recovery was uneventful.

Grossly the cyst cavity was filled with greyish putty like material. Histopathology of the cyst indicated the diagnosis of dermoid cyst, which was confirmed on microscopic examination by the presence of stratified squamous epithelium, sebaceous glands and numerous hair follicles with hair shafts.

Dermoid cysts are treated with complete surgical excision, the prognosis is good, and no further complications are expected.