A diagnostic dilemma: unusual case report of a dermoid cyst embellished with a tattoo in the midline of neck

Dermoid cysts are benign congenital tumours of ectoderm origin usually arising from the midline where fusion embryonic structures both sides occurs. They true hamartomas focal malformations that can resemble neoplasms grossly and even microscopically. We hereby presented a case 25 year old male with complaints neck swelling for 5 years which was found just beneath symbol tattooed in skin overlying swelling. The USG, fine needle aspiration cytology multislice CT scan reports strongly suggested findings dermoid cyst. However, there diagnostic challenge faced when chest granulomatous changes around region. After thorough history taking, physical examination radiological investigations, successfully excised complete margin sent histo-pathological examination, results correlated initial diagnosis it being cyst foreign-body reactions.