Clinical, radiological and histopathological characteristics of surgically removed orbital hematic cysts: A case series

Abstract

Hematic cyst is a challenging clinical diagnosis that can be aided by radiological examination and histopathological confirmation. Trauma does not seem to play a major role while presence of a pre-existing vascular lesion with spontaneous hemorrhage may be an etiologic factor. Associated cholesterol granuloma is an interesting controversial finding. Surgical intervention is curative with possible persisting motility disturbance and/or the eye deviation and worse prognosis in post-traumatic cases.

Orbital cholesterol granuloma: Report of two cases

“…Histological features of CG consist of cholesterol clefts surrounded by granulomatosis infiltration and homogenous debris without endothelial lining. 9 Because the lacrimal fossa is a common site for orbital CG, because it may cause bone erosion, orbital CG should be considered in the differential diagnosis of lacrimal fossa malignancies. In our cases, characteristic features of CG were reported in histologic evaluation.…”

Cystic Lesions of the Orbit

“…37,75,76 They are wellcircumscribed masses most commonly located in the intraconal or extraconal spaces of the superior orbit, often with frontal bone and/or orbital roof defect. 79,80 They may contain both cystic and solid components and, rarely, may extend through a congenital, traumatic, or iatrogenic bony defect to involve an adjacent sinus cavity. 79,80 They are usually readily identifiable on MRI due to their characteristic hyperintensity or mixedintensity appearance on both T1-weighted and T2-weighted images, reflecting their high protein content.…”

“…Hematic cysts have a nonspecific appearance on CT imaging, appearing as a subperiosteal lenticular mass with enlargement and erosion of the orbital cavity and a homogenous or heterogenous contents, depending on the stage of blood breakdown 37,75,76 . They are well-circumscribed masses most commonly located in the intraconal or extraconal spaces of the superior orbit, often with frontal bone and/or orbital roof defect 79,80 . They may contain both cystic and solid components and, rarely, may extend through a congenital, traumatic, or iatrogenic bony defect to involve an adjacent sinus cavity 79,80 .…”

“…79,80 They may contain both cystic and solid components and, rarely, may extend through a congenital, traumatic, or iatrogenic bony defect to involve an adjacent sinus cavity. 79,80 They are usually readily identifiable on MRI due to their characteristic hyperintensity or mixedintensity appearance on both T1-weighted and T2-weighted images, reflecting their high protein content. 37,79 Thus, a hematic cyst can be clearly differentiated from a subperiosteal tumor or abscess, both of which usually demonstrate low T1-weighted signal intensity.…”