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An orbital calcific cyst following exenteration.

Naomi Hasegawa1, Jiawei Zhao2, Daniel A Greninger3

  • 1Department of Ophthalmology, University of Texas at Houston, Houston, Texas, USA.

Orbit (Amsterdam, Netherlands)
|December 27, 2022
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Summary

This case report details a rare bone-like calcific cyst formation in an exenterated orbit. It highlights dystrophic calcification of retained blood as the likely cause following orbital surgery.

Keywords:
Orbital calcific cystdystrophic calcificationhyperostosisorbital exenterationosseous metaplasia

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Area of Science:

  • Ophthalmology
  • Pathology
  • Surgical Oncology

Background:

  • Orbital exenteration is a radical surgical procedure for advanced orbital malignancies.
  • Lid-sparing reconstruction aims to preserve ocular adnexa function post-exenteration.
  • Recurrent sebaceous carcinoma necessitates aggressive management, including exenteration.

Observation:

  • A 77-year-old female presented with a fluid-like sensation in her left orbit post-exenteration.
  • Magnetic resonance imaging (MRI) revealed a cyst-like cavity with bright T2 signal.
  • Intraoperative findings included a hard, bone-like calcified cavity.

Findings:

  • Surgical excision successfully removed the calcified orbital cavity.
  • Histopathology confirmed dense fibrous connective tissue with dystrophic calcification.
  • No evidence of osseous metaplasia was identified, ruling out true bone formation.

Implications:

  • This case illustrates a rare complication of orbital exenteration: dystrophic calcification.
  • Understanding this phenomenon is crucial for accurate diagnosis and management of post-exenteration orbital changes.
  • Highlights the importance of thorough histopathological examination of orbital post-surgical sequelae.