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Orbital dermoid cyst presenting as chronic osteomyelitis.

Bipasha Mukherjee1, Manideepa Banerjee2, Sumita Agarkar2

  • 1Orbit, Oculoplasty, Reconstructive & Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, India.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
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Summary

Dumbbell dermoid cysts, rare growths along embryonic lines, can be misdiagnosed. Surgical exploration revealed a dumbbell dermoid cyst in a young boy, correcting a chronic osteomyelitis diagnosis.

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Area of Science:

  • Ophthalmology
  • Plastic Surgery
  • Pediatric Surgery

Background:

  • Dermoid cysts are choristomas originating from displaced ectoderm along embryonic fusion lines.
  • Rarely, dermoid cysts present as dumbbell-shaped masses with superficial and deep intraorbital components, connected via a bony defect.

Observation:

  • A pediatric case initially diagnosed with chronic osteomyelitis of the zygoma based on clinical and radiological findings.
  • Surgical exploration identified a dumbbell-shaped dermoid cyst with an underlying bony defect.

Findings:

  • Histopathological examination confirmed the diagnosis of a dermoid cyst.
  • The cyst exhibited features of chronic inflammation.

Implications:

  • This case highlights the importance of considering dumbbell dermoid cysts in the differential diagnosis of zygomatic bone lesions, even when presenting with features mimicking osteomyelitis.
  • Accurate diagnosis through surgical exploration and histopathology is crucial for appropriate management and to avoid misdiagnosis in pediatric patients.