Intradiploic Epidermoid Cyst of Frontal Bone With Spontaneous Fistulization to Eyelid

Abstract

Dermoid and epidermoid cysts are choristomas that form due to the entrapment of epithelial remnants within the bony suture lines during embryologic development, around third and fifth week of gestation. Although these rare cysts, particularly the epidermoids, are most often seen in the cranial bones, they only constitute about 1% of all cranial tumors. Approximately, 25% of cranial epidermoids form in the diploic space of the membranaous bones of the skull, hence called intradiploic cysts. We describe the clinical manifestations and treatment of an intradiploic epidermoid cyst (IEC) of the orbital part of the frontal bone, which caused skin fistulization to the lateral aspect of the left upper eyelid. Clinical and surgical features are discussed and the pathogenesis of the skin fistula is analyzed.

Differentiating intradiploic orbital dermoid and epidermoid cysts utilizing clinical features and machine learning

“…Intradiplopic orbital dermoid and epidermoid cysts are rare, benign tumors, with only 49 cases reported in the literature. [ 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 ] Orbital dermoid cysts are far more common and are most often periocular, with several large series reporting over 80% presenting as a subcutaneous mass. [ 1 52 ] Deep orbital dermoid cysts, also referred to as endophytic cysts, have also been reported, and are more often present later in life with orbital inflammation.…”

Asymptomatic Intradiploic Epidermoid Cyst Eroding Frontal Bone in a Patient With Craniosynostosis

“…4 In undiagnosed late-presented case seizures, visual field defect or intracerebral hematoma may occur. 1,3,5 We report an asymptomatic intradiploic epidermoid cyst eroding the frontal bone in a patient with craniosynostosis and discuss the potential impact on cranioplasty.…”

“…[1][2][3][4][5] This is particularly true for incomplete Le Fort or "greenstick" fractures. In such circumstances, it is often extremely difficult, if not impossible, to completely disimpact the maxilla.…”

“…This often leads the surgeon to literally force a maxillary repositioning in an attempt to reduce the fracture and to obtain a satisfactory intraoperative occlusal relationship. [1][2][3][4][5] In so doing, the dental occlusion is often "locked" with the condyles improperly positioned too far posteriorly and/or inferiorly. The condylar malpositioning is certainly the main etiopathogenic factor involved in the postoperative malocclusion that can typically occur immediately after release of the maxillomandibular fixation (MMF).…”

“…In fact, the condyles regaining their original position into the glenoid fossa lead to a relative prognathism and/or anterior or lateral open bite malocclusion. 3,5 Thus, in some specific cases, the completion of the fracture by performing an additional contralateral maxillary osteotomy becomes a logical and unavoidable necessity to obviate this rare but insidious occlusal drawback.…”