Eshraghi B, Shahsanaei A, Abounoori M, Pourazizi M. Atypical intraorbital dermoid and epidermoid cyst: A single institution cross-sectional retrospective study.
Ann Med Surg (Lond) 2022;
79:103997. [PMID:
35860165 PMCID:
PMC9289341 DOI:
10.1016/j.amsu.2022.103997]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/10/2022] [Accepted: 06/12/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose
Intraorbital epidermoid and dermoid cyst (DC) has been reported in the literature rarely. The current study evaluates clinicopathologic, radiologic, and management of intraorbital DC cases over ten years.
Methods
In this cross-sectional study, the medical records of patients with intraorbital DC treated at the academic referral center for ocular surgery were retrospectively reviewed. Data reviewed included the patient's demographic characteristics, clinical features, imaging, surgical technique, and pathology report.
Results
Nine patients with a rare presentation of intraorbital DC were reviewed within the study period in five presentations (five intraosseous, one intraconal, one dumbbell-shaped with a large part in anterior orbit, one juxta levator palpebral muscle, and one recurrent case with intracranial extension). They ranged from 8 to 53 years of age, with a median of 29 years, and five (55.6%) were female. Histopathological evaluation revealed two cysts were epidermoid.
Conclusion
The current study provides more clinical and radiologic manifestations of rare presentations of DC that highlight the importance of high clinical suspicion in the approach to atypical DC.
The mean age of patients with intraorbital dermoid/epidermoid cyst was higher than periocular that usually present in early infancy.
The most clinical signs of patients with intraorbital dermoid/epidermoid cyst were hypophthalmos, proptosis, lid puffiness, and ptosis.
In addition to the atypical clinical presentation of intraorbital dermoid/epidermoid cyst, the radiological investigation is doubted potentially and can be caused mixed missed cases. So histopathological evaluation is essential for confirmation of the diagnosis.
It may be difficult or impossible to excise a complete intraosseous dermoid/epidermoid cyst. In such cases, evacuating cyst contents allowed for easier dissection around the lesion. In addition, burring the bone is necessary in cases where there is an intimate connection of the cyst wall to the bone.
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