A rare case of a cutaneous ciliated cyst of Mullerian origin found in the lower extremity: A case report

Abstract

Cutaneous Ciliated Cyst (CCC) of Mullerian origin are rare, benign, soft tissue tumors with less than 60 reported occurrences reported in literature, none in foot and ankle publications. Most of these lesions occur in the lower extremity of women of child-bearing age. We present a case involving a 33-year-old female who presented with a painful soft tissue mass to the right hindfoot. Physical examination demonstrated a well-circumscribed, adhered soft tissue lesion proximal to the 5th metatarsal base. Conservative treatment failed to relieve symptoms. MRI demonstrated a lobulated collection of fluid in the area of the soft tissue lesion. The mass was surgically excised and sent to pathology. Histopathologic and immunohistochemical examination showed pseudostratified cuboidal to columnar epithelial lining with nuclear positivity for estrogen and progesterone receptors, a benign lesion with lineage from the Mullerian duct. The patient was followed for 14+ months and has subsequently recovered without complications or recurrence. We aim to illustrate characteristics that define these rare lesions and further educate foot and ankle surgeons on CCC management.

Keywords

• Foot and ankle
• Surgery
• Soft tissue mass
• Pathology
• Cutaneous ciliated cyst
• Mullerian