Epidermoid cyst of the upper eyelid tarsal plate

A 78-year-old white man presented with a painless, right upper eyelid mass causing mechanical ptosis. There was no prior history of trauma, surgery, or eyelid inflammation. Examination revealed a firm, globular mass that was fixed to the tarsal plate of the upper eyelid. Excisional biopsy performed through an upper eyelid crease incision revealed a mass securely attached to the tarsal plate which upon separation leaked cheesy, malodorous material. Histopathologic sections demonstrated a cyst lined by squamous epithelium containing laminated keratin consistent with a diagnosis of an epidermoid cyst. The authors report, to their knowledge, the first description of an epidermoid cyst of the tarsal plate. As with epidermoid cysts in other locations, surgical excision is the treatment of choice.