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Intraorbital dermoid cyst

Case contributed by Frank Gaillard

Presentation

Diplopia

Patient Data

Age: 40 Years
Gender: Male
ct

At the lateral aspect of the orbit is a well circumscribed mass with a fat fluid level. It displaces the globe and results in proptosis. There is associated extension through the bone in the middle cranial fossa. 

mri

A 2.4 x 2.4 x 3.0 cm left orbital wall lesion is demonstrated, which is sharply circumscribed, cystic in nature, containing an anti-dependent liquid fat component (sebum) and a dependent fluid component. No solid enhancing component can be identified. Medially it displaces the superior rectus/LPS complex medially, and the lateral rectus inframedially, and results in moderate proptosis. Laterally a tail of the cyst extends through the lateral wall of the orbit curving around the margin of the orbital rim deep to the temporalis. Posteriorly the bone is deficient in a number of areas with the cyst communicating with the middle cranial fossa with no evidence of extension into the intracranial compartment, and no changes in the adjacent (abutting) temporal pole.

The remainder of the study is unremarkable in appearance.

Conclusion:

Large left intraorbital (deep) dermoid with extension through the lateral wall of the orbit into the infratemporal fossa and posteriorly into the middle cranial fossa.

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