External angular dermoid cyst

Case contributed by Dr Salahouddin Asadullah

Presentation

Swelling left lateral orbit inseparable from eyelid since birth

Patient Data

Age: 1 year
Gender: Male

Well defined cystic lesion in subcutaneous plane of lateral margins of orbit on left. No intraorbital extension. Underlying bone and adjacent lacrimal gland are unremarkable.

Opacification of left mastoid and middle ear cavity-otomastoiditis.

Opacification of left ethmoid and bilateral maxillary sinuses-sinusitis.

Brain parenchyma appears unremarkable.

Case Discussion

Orbital dermoid is the most common orbital mass in children. The differential is an epidermoid cyst. Though no fat density observed in this case, typically orbital dermoids are heterogeneous with soft tissue, fluid and fat density with occasional calcifications. 

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