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Epidermoid-induced pulsating eye

S R Bitar1, J B Selhorst, C R Archer

  • 1Department of Neurology, School of Medicine, Saint Louis University, Missouri.

Annals of Ophthalmology
|February 1, 1993
PubMed
Summary
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A pulsating eye in an asymptomatic woman was caused by an epidermoid cyst. This temporal lobe mass extended into the orbit, highlighting epidermoid tumors as a cause of pulsating eyes.

Area of Science:

  • Neurology
  • Ophthalmology
  • Radiology

Background:

  • Epidermoid cysts are rare congenital tumors that arise from displaced ectodermal tissue.
  • They are typically found along the cleavage lines of the central nervous system.
  • Pulsating exophthalmos is a rare condition often associated with vascular abnormalities.

Observation:

  • A 62-year-old woman presented with a pulsating, but not proptotic, eye.
  • Imaging revealed a low-density mass in the temporal lobe extending through the sphenoid bone into the orbit.
  • The lesion displaced the optic nerve and indented the lateral rectus muscle.

Findings:

  • Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a non-enhancing, low-density mass.
  • The cyst's location in the temporal lobe's cleavage lines, irregular margins, and imaging characteristics were consistent with an epidermoid cyst.

Related Experiment Videos

  • Orbital invasion by the temporal lobe mass was confirmed.

    • Implications:

    • This case expands the differential diagnosis for pulsating exophthalmos.
    • It underscores the importance of advanced neuroimaging in diagnosing orbital and intracranial pathologies.
    • Epidermoid cysts should be considered in the evaluation of unexplained pulsating eye symptoms.