Ophthalmic presentation of epidermoid cysts in an African community

This retrospective study reviews the clinical and histopathological features of ocular epidermoid cyst. The 30-year laboratory records of all the patients of the Igbo ethnic group, whose surgical specimens were received at a central pathology laboratory service in south-eastern Nigeria, West Africa, were reviewed. The cases with the histopathologic diagnosis of epidermoid cyst involving ocular tissues were reviewed. The data analyzed included age at diagnosis, sex, location and size of cyst, clinical description of lesion and operative diagnosis. There were eighteen patients. Ten (55.6%) of these were males and 8 (44.4%) were females. Nearly three-quarters were below the age of 20 years. The cyst was present from birth in 4 (22.2%) patients and was acquired in the rest. It occurred on the external angle of the orbit in 7 patients; on the bulbar conjunctiva in 4 patients; in the lower fornix, upper lid and medial canthus in two patients each; and on the lower lid in one patient. There was no correct diagnosis of epidermoid cyst clinically, the most common misdiagnoses being dermoid cyst (55.6%) and conjunctival cyst (16.7%). Accordingly, epidermoid cyst should be included in the differential diagnosis of cystic lesions showing ophthalmic presentation.