Orbital apocrine hidrocystoma with ptosis

To describe a patient with orbital apocrine hidrocystoma presenting with ptosis and subsequent management.

A 43-year-old woman presented to the oculoplastic surgery clinic with a left-sided ptosis and enlarging but painless mass in the sulcus of the left upper eyelid. Magnetic resonance imaging demonstrated a large, circumscribed T2 bright cystic lesion in the extraconal space. Surgical excision and histopathology confirmed a diagnosis of apocrine hidrocystoma.

Although uncommon, ptosis may be a presenting symptom of an orbital apocrine hidrocystoma, which should be considered in the differential diagnosis for an extraconal cystic lesion. Apocrine hidrocystomas are benign tumors and are cured with surgical excision with rare recurrence.