Purpose or Case Report: Dermoid cysts are a sequestration of ectoderm containing secondary skin structures, usually at characteristic locations of embryologic fusion lines. The midventral suprasternal fusion line is one such location in the developing embryo with both simple and complicated dermoids of this region reported in the literature. We reviewed our academic pediatric institutional experience with dermoid cysts of the suprasternal notch, focusing on the initial presentation as a palpable nodule referred for sonographic evaluation.

The purpose of this educational exhibit is to depict the ultrasound imaging features of suprasternal notch dermoid cysts in the pediatric population.

Secondary purposes are to describe the anatomy of the suprasternal notch, demonstrate CT and MR correlates of the these dermoids, and depict regional inflammatory complications.
Methods & Materials: 47 retrospective cases aged from 2 months to 13 years were collected utilizing an electronic database of radiology reports at our academic children’s hospital from January 2008 to July 2018. Many cases were confirmed either with typical MR appearance or excisional biopsy.
Results: Suprasternal notch dermoid cysts demonstrate specific sonographic findings:

(1) circumscribed ovoid mass located between the sternornohyoid muscles in the midline
(2) longitudinal orientation
(3) homogeneously echogenic with some of them showing small internal anechoic areas
(4) posterior acoustic enhancement
(5) absence of internal Doppler blood flow
Conclusions: Characteristic location of a nodule in the suprasternal notch and specific sonographic findings allow for a confident radiologic diagnosis of a dermoid cyst without the need for additional imaging.