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Chewing-induced visual impairment from a dumbbell dermoid cyst
G T Emerick1, C L Shields, J A Shields
1Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania 19107, USA.
Ophthalmic Plastic and Reconstructive Surgery
|March 1, 1997
Summary
A dermoid cyst caused blurred vision in a woman by compressing orbital contents during chewing. This case highlights how these cysts, often linked to bone defects, can present with unusual symptoms.
Area of Science:
- Ophthalmology
- Dermatology
- Neurosurgery
Background:
- Dermoid cysts are congenital tumors that can occur in various locations, including the orbit.
- They are typically benign but can cause significant symptoms due to mass effect.
- Association with bony defects is common, necessitating careful preoperative evaluation.
Observation:
- A 29-year-old woman experienced a year of blurred vision in her left eye, specifically while chewing.
- Physical examination revealed a palpable, ill-defined, rubbery mass in the superotemporal brow region.
- Imaging demonstrated a dumbbell-shaped cystic lesion extending from the temporal fossa into the orbit via a lateral orbital wall defect.
Findings:
- Histopathological analysis of the excised mass confirmed it as a dermoid cyst of cutaneous origin.
- The cyst's unique dumbbell configuration allowed it to be compressed into the orbit during mastication.
- This compression transiently displaced orbital contents, leading to the patient's visual disturbances.
Implications:
- This case illustrates an unusual presentation of a dermoid cyst causing intermittent visual symptoms related to mastication.
- The presence of a bony defect is a critical factor to consider in the diagnosis and management of orbital dermoid cysts.
- Preoperative imaging is essential for identifying bony defects and anticipating potential complications or unexpected symptoms.