Pediatric Nasal Dermoid

  • Etiology:
    — Dural diverticulum persists longer than normal and remains in contact with nasal dermal structures and can drag nasal dermal structures back with it as it regresses
    — Ectoderm is lining of dermal sinus and may result in dermoid or epidermoid masses developing along tract
  • Imaging:
    — Can be midline from skull base at foramen cecum to tip of nose
    — May have an associated sinus track
    — Patent and enlarged foramen cecum
    — Bifid crista galli
    — Fatty mass in bifid or split nasal septum
  • DDX: Nasofrontal or nasoethmoidal cephalocele, nasal glioma
  • Complications:
  • Treatment: Surgical
  • Clinical:
    — Nasal bridge swelling
    — May have characteristic nasal pit
    — Can occasionally express fluid

Radiology Cases of Nasal Dermoid

MRI of nasal dermoid
Sagittal T1 MRI without contrast of the face (left) shows a small round lesion of high signal intensity at the tip of the nose which on sagittal T1 MRI with contrast and fat suppression (right) is of low signal intensity (fat suppressed) and to have no enhancement. There was no intracranial connection.