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Ruptured orbital dermoid cyst

Case contributed by Ahmed Haroun
Diagnosis almost certain

Presentation

Presented with clinical picture of right orbital cellulitis.

Patient Data

Age: 18
Gender: Male

Ct orbits

ct

CT scan shows cystic lesion in the extraconal superomedial aspect of the right orbit. It contains fat and fluid. Perilesional inflammatory changes are noted which extends into the upper lid. The cyst wall appears thick, enhancing with focal point of interruption (arrow). 

Case Discussion

This case illustrates an orbital dermoid cyst complicated by rupture and acute inflammation. 

Orbital dermoid usually presents as a painless subcutaneous mass.

If the cyst ruptures, either spontaneously or with trauma, a pronounced inflammatory response will occur that may mimic orbital cellulitis or inflammatory rhabdomyosarcoma. The inflammation may be suppressed by corticosteroids, but excision is required to prevent recurrence.

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