An unusual eyelid mass: Tarsal dermoid cyst

We report the case of a 15-month-old boy who presented with a mass lesion of the right upper eyelid that had been present since birth and had slowly enlarged over the last 3 months. The lesion had minimal surrounding erythema simulating the appearance of a chalazion. Intraoperatively the lesion was noted to be firmly adherent to the underlying tarsus. The lesion was excised completely through an eyelid crease approach leaving the tarsus intact. The histopathology was consistent with dermoid cyst. To our knowledge, this is the third case of a tarsal dermoid cyst reported in the literature. Dermoid cyst should be included in the differential diagnosis of eyelid mass lesions, and particulary differentiated from a chalazion to avoid mismanagement that may lead to scarring, recurrence and inflammation. The excision of these lesions sparing the underlying tarsus can be possible.