Question: Dear Dr. Soukup, My 2 month old has a lump over her right eyebrow that I just noticed. It doesn’t seem to bother her. What could this be? Melissa B.
I see lots of kids with “lumps and bumps” most of which are not worrisome, but sometimes need biopsy or removal. This particular lump that you describe is a classic location for something called a “Dermoid cyst”. It is a soft lump felt most commonly at the outside corner of the eyebrow, and is usually present at birth. It can also be found around the ear, or in the midline of the scalp or neck. Early in development before a baby is born, there are se-veral folds of skin and tissue which fuse together in an amazing way to form the features of our face and neck. Rarely, as this fusion happens, a small piece of skin can become trapped under the surface of the skin and can grow as a cyst. “Dermoid” refers to the skin layer (think of the word Dermatologist). The term “cyst” just refers to a mass or lump which contains fluid or soft contents (in this case, soft exfoliated skin cells). This is not a dangerous growth, but it does get larger with time as the cyst fills with these skin cells, just like our normal skin exfoliates old skin cells. For this reason, I usually recommend having this cyst removed before it gets too large. There is no urgent need for this to be done in the first months of life when the anesthesia and neurodevelopmental risks are higher, so I usually recommend waiting until 1 year of age or after. Obviously parents are nervous about surgery for their child, particularly with something of such cosmetic importance on the face. Traditionally, the scar can be made quite small either above or below the eyebrow, but often I can completely hide it within the eyelid crease making it essentially invisible later on. This heals beautifully and parents are usually very surprised and happy with the result.
Thanks for your question! – Dr. Soukup
Elizabeth S. Soukup, M.D., M.M.Sc.
Dr. Soukup is a Pediatric Surgeon at the Elliot Hospital and has an interest in educating families about pediatric health and wellness. Her mission is to provide expert specialty care for children of all ages in New Hampshire – newborns through teenagers – striving to keep them close to their families and communities. If you would like more information, call 603-663-8393 for an appointment, or visit our website at Dr. Soukup earned her Bachelor of Science from the Massachusetts Institute of Technology and her Doctor of Medicine from the University of Chicago Pritzker School of Medicine, where she received the Outstanding Achievement Award in Medicine, graduating first in her class. She completed her General Surgery training at the Massachusetts General Hospital and her fellowship in Pediatric Surgery at Children’s Hospital Boston. During her time in Boston, she also completed a Masters of Medical Sciences degree in clinical investigation from Harvard Medical School. She was awarded Elliot Hospital’s “Physician of the year” for 2018. She is board-certified in both Pediatric Surgery and General Surgery. She has specialized training and experience in minimally invasive surgical treatment for babies, children and teenagers. Her practice includes all areas of general pediatric surgery, including common pediatric surgical problems as well as neonatal surgery, congenital anomalies, minimally invasive surgery, and complex thoracic surgical problems.
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