Periorbital lesions misdiagnosed as dermoid cysts

Several periorbital lesions can be clinically misdiagnosed as dermoid cyst. We retrospectively reviewed the histopathological findings for 97 biopsied periorbital lesions with a clinical diagnosis of dermoid cyst from January 2006 to July 2016 at a single center and identified 5 cases that were eventually found to have been misdiagnosed. The main presenting symptom was a long-standing mobile painless mass with intact overlying skin below the medial aspect of the brow in 4 patients and below the center of the brow in 1 patient. The tissue diagnoses included vascular lesions (hemangiomas and cavernous venous malformation) in 4 patients and pilomatrixoma in 1 patient. The agreement between the clinical and pathological diagnosis of a periocular dermoid cyst in our series was 94.8%.