Orbital epidermoid cysts: a diagnosis to consider

Area of Science:

• Ophthalmology
• Neurosurgery
• Pathology

Background:

• Orbital epidermoid cysts are rare, distinct pathological entities separate from dermoid cysts.
• They present with diverse clinical and radiological features, necessitating their inclusion in the differential diagnosis of orbital cystic lesions.
• This study investigates 17 cases to detail their presentations and surgical outcomes.

Purpose of the Study:

• To describe the clinical and radiological presentations of orbital epidermoid cysts.
• To evaluate the surgical outcomes and recurrence rates of these lesions.
• To differentiate orbital epidermoid cysts from other orbital cystic pathologies.

Main Methods:

• A prospective interventional study involving 17 patients diagnosed with orbital epidermoid cysts.
• Comprehensive recording of patient symptoms and clinical signs.
• Diagnostic imaging via CT scan, surgical excision via anterior orbitotomy, and histopathological confirmation.

Main Results:

• The mean patient age was 16.3 years.
• Common symptoms included lid swelling, masses, ocular asymmetry, pain, and proptosis.
• Radiological findings varied, with homogenous hypodense masses being most common (58.8%).
• No recurrences were observed during a mean follow-up of 18.8 months post-surgery.

Conclusions:

• Orbital epidermoid cysts are a distinct entity, potentially behaving like deep orbital epidermoids but typically presenting at an older age.
• These cysts can increase orbital volume without necessarily being linked to bony sutures.
• Surgical intervention via anterior orbitotomy offers a definitive treatment with no observed recurrence.