Dermolipoma of the orbit

Discussion:

Dermolipoma is a congenital lesion closely related to limbic dermoid cyst of the eye. Both are choristomas, often covered by fine hairs on the surface. However, other than dermoid cysts, dermolipomas almost exclusively consist of mature fat tissue1. Detection is typically delayed until adulthood (median age of 22,5 years). 

The lesion is rare and can be diagnosed clinically, therefore there is sparse imaging literature on the subject. Differentiation from dermoid cysts in younger patients, and subconjunctival fat prolapse in the elderly is important, for operative treatment of dermolipoma often entails severe complications. Total excision is contraindicated. Cautious debulking is the method of choice2.

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