Presentation
Hard swelling at the right supraorbital region.
Patient Data
Expansile intradiploic lytic lesion of right supraorbital location with a cortical defect and intraorbital extension. The content of the lesion appears homogeneous with no enhancement.
On MRI sequences, this lytic lesion shows a high signal on T1, T1 fat sat, and T2 with a homogeneous content. No restricted diffusion on DWI/ADC or enhancement on postcontrast sequences. The intraorbital component compresses and displaces the lacrymal gland and the superior rectus muscle as well as the eye globe.
CT follow-up after resection of the lesion.
Case Discussion
CT and MRI features of an intradiploic supraorbital expansile cystic lesion of high signal on T1 with no restricted diffusion suggestive of a white epidermoid cyst (pathologically proved).
The high signal on T1 sequences is due to the high protein or keratin content with variable signal on T2 sequences (hypo or hypersignal) and restricted diffusion.