Epidermoid cyst and cholesterol granuloma of the orbit

Epidermoid cyst and cholesterol granuloma have been confused, but these are different lesions. A case of recurrent orbital epidermoid cyst and another case of orbital cholesterol granuloma are presented in order to describe their distinct pathological, clinical and imaging characteristics and their surgical management. Advanced investigation using our custom-designed three-dimensional imaging allowed a better appreciation of the exact location, and optimal planning of the surgical treatment. The same surgical approach was used for both lesions: total resection via a coronal incision and immediate reconstruction of residual defects using skull bone grafts.