Temporal dermoid--an unusual presentation

It is rare for a frontotemporal dermoid cyst to present as a discharging sinus, and even more rare for it to have intracranial extensions. Only a few cases of intraorbital extension have been reported. We report a 14-month-old girl who presented with all the aforementioned features. She had a temporal dermoid with three discharging sinuses over the temporal area, lower lid, and cheek. It also had an intraorbital extension through the lateral orbital wall and an intracranial extension through the temporal bone. Preoperative computed tomography was done as there was a history of "orbital cellulitis". Excision of the cyst was done using a hemicoronal-preauricular incision. A lateral orbitotomy was required to remove the orbital component in continuity with the rest of the cyst.