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Epidermal inclusion cysts are common tumours of the hand in industrial workers caused by entrapment of epidermal elements within the dermis. They are unusual in the head and neck region more so in the temporal region. We present a 27-year-old man with a 3-month history of a slow-growing swelling in the left temporal region. He had a history of chronic otitis media and underwent an end-aural tympanomastoid surgery 5 years earlier. Physical examination revealed a 5 × 3 × 2.5 cm cystic globular minimally tender mass in the temporal fossa along with squamous active otitis media with bony erosion of the outer attic wall. High-resolution computed tomography of the left temporal bone revealed otomastoiditis with erosion of the scutum; ossicles were not identified. We hereby describe the diagnostic challenge and the plan of management of this lesion. Epidermal inclusion cyst must be considered in the differential diagnosis of temporal fossa lesions especially in patients with a prior history of ipsilateral tympanomastoid surgery.

A rare case of epidermal inclusion cyst: an unusual complication of ear surgery