Clinical Outcomes of Ruptured Periorbital and Orbital Dermoid Cysts

Siah, We Fong; Al-Muhaylib, Ahmed; Rajak, Saul; Ziahosseini, Kimia; Selva, Dinesh; Malhotra, Raman; Alsuhaibani, Adel H.

doi:10.1097/iop.0000000000000735

Cited by 14 publications

(12 citation statements)

References 10 publications

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“…In a retrospective multicentric study, cases from 3 oculoplastic centers (Queen Victoria Hospital, East Grinstead, United Kingdom; King Abdulaziz University Hospital, Riyadh, Saudi Arabia; South Australian Institute of Ophthalmology and Visual Sciences, Australia) over a 10-year period, 29 of the total 86 cases were ruptured and only 2 were reported as spontaneous rupture. In the same study, it was pointed out that persistent inflammation was more pronounced after spontaneous rupture [11]. Our case was compatible with inflammation by ruptured dermoid cyst condition, in which infection and other causes are eliminated.…”

Section: Case Reportsupporting

confidence: 80%

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Orbital inflammatory disease in a child caused by a ruptured dermoid cyst misdiagnosed as orbital cellulitis

Bozkurt

Soysal

2021

Marmara Medical Journal

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One of the most common orbital tumors in childhood is orbital dermoid cysts. Cyst rupture or leakage of the cyst content is one of the rare causes of orbital inflammations and needs to be caught early. A five and a half year old boy was referred to us with the diagnosis of orbital cellulitis resistant to antibiotic therapy. Regarding his detailed medical history, physical examination and laboratory tests findings, he was diagnosed as orbital inflammatory disease caused by dermoid cyst rupture. He underwent surgical excision of the cyst after the inflammation was resolved with a short course of anti-inflammatory treatment. Although, it is rare, dermoid cyst rupture is one of the important causes of orbital inflammatory diseases and it must be kept in mind in the differential diagnosis of orbital infections. A detailed history and a careful examination helped us to make the correct diagnosis and avoided diagnostic delay and unnecessary treatment.

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Section: Case Reportsupporting

confidence: 80%

“…Dermoid cysts constitute 5% of all orbital lesions in childhood [3]. These lesions are assumed to originate from ectodermal tissue deviating from sequencing that occurs when suture lines are closed during embryonic development [4,5]. Cyst rupture or leakage of the cyst content is one of the rare causes of orbital inflammation.…”

Section: Introductionmentioning

confidence: 99%

Orbital inflammatory disease in a child caused by a ruptured dermoid cyst misdiagnosed as orbital cellulitis

Bozkurt

Soysal

2021

Marmara Medical Journal

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“…En block removal of the orbital dumbbell dermoid cysts is often difficult as they are tightly adhered to the bones at the frontozygomatic suture. 1 , 2 , 6 Therefore, an accidental cyst rupture occasionally occurs, which also happened in the present case. Several surgical techniques have been reported to avoid unintended surgical rupture.…”

Section: Discussionsupporting

confidence: 69%

“…They sometimes rupture spontaneously, which causes inflammation of the eyelids and orbits. 2 A complete removal is mandatory to avoid postoperative recurrence and inflammation. 3 …”

Section: Introductionmentioning

confidence: 99%

Rescue technique for complete removal of an accidentally ruptured orbital dumbbell deep dermoid cyst: A case report

Lin

Kitaguchi

Mupas-Uy

et al. 2018

American Journal of Ophthalmology Case Reports

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PurposeTo report a rescue technique for complete removal of an accidentally ruptured orbital dumbbell deep dermoid cyst.ObservationsA 33-year-old female presented with left proptosis with retrobulbar discomfort for 3 months. Computed tomography images showed an orbital dumbbell deep dermoid cyst. A lateral orbitotomy was performed under general anesthesia. The cyst was ruptured during osteotomy of the lateral orbital rim. The cyst was opened vertically from the ruptured site using a Stephen's tenotomy scissors to visually confirm the internal wall of the cyst and to keep the epithelial lining intact while separating the external wall of the cyst from the bone. There was a small defect of the epithelial lining at the inferoposterior margin of the cyst. Granulomatous inflammation of the lacrimal gland was found adjacent to the defect site. The cyst was completely removed and the lacrimal inflammation subsided after the operation.Conclusions and importanceOpening of the cyst is a useful technique to remove the entire epithelial lining of an accidentally ruptured dumbbell dermoid cyst.

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“…2 In our series intraoperative rupture occurred in significantly more number adults as compared to children. Siah et al 24 reported that the risk of persistent inflammation is small in surgically ruptured cyst, where the spillage of cyst contents has been dealt with meticulously. 24 Furthermore, in cases of spontaneous cyst rupture there is a high risk of persistent inflammation, hence supporting the benefit of operating early.…”

Section: Discussionmentioning

confidence: 99%

Orbital and periorbital dermoid cysts: Comparison of clinical features and management outcomes in children and adults

Dave

Rathi

Kaliki

et al. 2020

European Journal of Ophthalmology

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Purpose: To compare differences in clinical presentation and management outcomes of orbital and periorbital dermoid cysts in children and adults. Methods: A retrospective interventional comparative consecutive case series. 203 patients in (148 children [Age ⩽18 years] and 55 adults [Age >18 years]), who underwent excision biopsy for orbital/periorbital dermoid cyst were included. Outcome measures included the differences in demography, clinical presentations, radiological features, surgical outcomes and histopathology of cysts between children and adults with dermoid cysts. Results: The mean age noted at excision was 15 years in this cohort of 148 children and 55 adults. Commonest clinical finding observed was a subcutaneous painless mass (94%) and external angular dermoids were commonest in both groups 1 and 2 (51% and 56%). Diminution of vision ( p = 0.007), proptosis ( p = 0.008), extraocular motility limitation ( p = 0.001), strabismus ( p = 0.003) and relative afferent pupillary defect ( p = 0.02) were significantly more in adults. Orbital involvement and dumbbell dermoids were not significantly different between children and adults. Radiologically, bony fossa formation ( p = 0.03), temporal fossa extension ( p = 0.04), full thickness bony defect ( p = 0.03) and intraosseous presentation ( p = 0.005) were significantly more in adults. Comparison of proportion of lesions having intra-operative rupture of dermoid cyst ( p = 0.009) and evidence of inflammation on histopathology ( p = 0.01) were significantly more in adults. However, recurrence rates were not different between children and adults. Conclusions: Dermoid cysts are commoner in children, but can also present in adulthood. Secondary visual, orbital, radiologic changes and intra-operative rupture of dermoid cyst are more common in adults compared to children.

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Clinical Outcomes of Ruptured Periorbital and Orbital Dermoid Cysts

Abstract: Persistent inflammation is uncommon after surgical rupture of dermoid cysts, but likely after spontaneous rupture. Older age and bony attachment are risk factors for cyst rupture.

Cited by 14 publications

References 10 publications

Orbital inflammatory disease in a child caused by a ruptured dermoid cyst misdiagnosed as orbital cellulitis

Orbital inflammatory disease in a child caused by a ruptured dermoid cyst misdiagnosed as orbital cellulitis

Rescue technique for complete removal of an accidentally ruptured orbital dumbbell deep dermoid cyst: A case report

Orbital and periorbital dermoid cysts: Comparison of clinical features and management outcomes in children and adults

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