Conjunctival cyst and conjunctival dermoid of the orbit

BACKGROUND. Conjunctival dermoids and conjunctival cysts of the orbit were first reported by Jakobiec et al. in 1978. Communications regarding this type of cysts have been sporadic. PATIENTS AND METHODS. We describe the clinical and histopathologic findings in two patients with histopathologically confirmed conjunctival dermoid and conjunctival cyst of the orbit. A review of the literature was also carried out. RESULTS. A 27-year-old female presented with a slowly growing tumor in her left orbit inferomedially. Histopathologically, the tumor was a conjunctival cyst. A 20-year-old male was seen with a painless, slowly-growing mass in his right orbit nasally. The histopathologic study disclosed a conjunctival dermoid. Echography was useful in both cases in demonstrating the cystic structure of the tumors. Conjunctival dermoids and cysts are usually noticed in adulthood, are located nasally or superonasally, lack an associated osseous defect and are lined by a non-keratinizing epithelium with goblet cells. CONCLUSION. Conjunctival dermoids and cysts of the orbit display clinical, radiologic and histopathologic features that differentiate them from the more common dermoid cysts. Emphasis must be given to these distinctive features, since these lesions have probably been largely misdiagnosed.