Epidermoid-induced pulsating eye

An otherwise asymptomatic 62-year-old woman had a pulsating but not proptotic eye. Computed tomography showed a low-density mass lesion in the temporal lobe that extended through a defective greater wing of the sphenoid, indented the lateral rectus muscle, and displaced the optic nerve. Magnetic resonance imaging confirmed these findings and showed no enhancement of the lesion by gadolinium. An epidermoid cyst was diagnosed on the basis of its location in the cleavage lines of the temporal lobe, irregular margins, low density by imaging scans, lack of enhancement, and invasion of the orbit. Epidermoid tumors are, therefore, another cause for a pulsating eye.