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CASE REPORT
Year : 2013  |  Volume : 40  |  Issue : 1  |  Page : 47-48

A rare site of epidermoid cyst of the eyelid


Department of Ophthalmology, JNMC, KLE University, Belgaum, Karnataka, India

Date of Web Publication28-Mar-2013

Correspondence Address:
Shivanand C Bubanale
Department of Ophthalmology, JNMC, KLE University, Belgaum, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-5009.109705

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  Abstract 

Epidermoid cysts are slow- growing, benign tumors that result from proliferation of epidermal cells within a confined space. Epidermoid cysts of the eyelid typically present during adolescence through adulthood as a solitary, elevated, round, freely mobile subcutaneous mass with smooth overlying skin. The most common site for the sebaceous or epidermoid cysts is the meibomian glands of the upper tarsus due to retention of meibomian gland material. We report a case of a 32- year- old male who presented with chief complains of painless swelling on the right upper lid since 1 year. It was an extrameibomian site, i.e., at the lateral superior aspect of the eyelid. It is a rare site for the epidermoid cyst to grow to such an extent. The lesion was excised completely, and histopathology confirmed the diagnosis of epidermoid cyst.

Keywords: Cyst, epidermoid, lid


How to cite this article:
Bubanale SC, Harakuni U, Patil H, Arora V. A rare site of epidermoid cyst of the eyelid. J Sci Soc 2013;40:47-8

How to cite this URL:
Bubanale SC, Harakuni U, Patil H, Arora V. A rare site of epidermoid cyst of the eyelid. J Sci Soc [serial online] 2013 [cited 2019 Jul 18];40:47-8. Available from: http://www.jscisociety.com/text.asp?2013/40/1/47/109705


  Introduction Top


Epidermoid cysts are slow-growing, benign tumors that result from proliferation of epidermal cells within a confined space. They differ from dermoid cysts only in that dermal appendages are lacking. [1],[2],[3] Both cyst types are composed of a true epidermal lining and typically contain laminated keratinaceous material. Epidermoid cysts of the eyelid typically present during adolescence through adulthood as a solitary, elevated, round, freely mobile subcutaneous mass with smooth overlying skin. [3] A central pore tethers the tumor to the overlying skin creating a firm connection.


  Case Report Top


A 32-year-old male presented with chief complains of painless swelling on the right upper lid since 1 year. The patient was aware of the swelling from last 1 year but it has enlarged in last 6 months. There was no history of any prior trauma, surgery, or eye lid inflammation.

Clinical features

A swelling at the lateral aspect of the right upper lid below the eyebrow measuring 1.5 × 1.0 cm [Figure 1] and [Figure 2] which was globular in shape with a smooth surface and margins was observed. The mass was non-tender and local temperature was not raised. It was firm in consistency, non-fluctuant, and non-translucent, fixed to the overlying skin but free from the underlying structures such as tarsus or the bone. There were no pulsations or bruits.
Figure 1: Preoperative image

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Figure 2: Preoperative image 2

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Investigations

Histopathological examination revealed 1 × 1.5 × 2.0-cm globular cyst with sebaceous cheesy material inside, suggestive of epidermoid cyst.

Treatment

Excision of the cyst under local anesthesia [Figure 3]. On 1 st post operative day patinet was comfortable and symptomless [Figure 4].
Figure 3: Intraoperative image

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Figure 4: Postoperative image

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  Discussion Top


There are several proposed mechanisms for epidermoid cyst formation. These include sequestration of epidermal rests along fusion planes during embryonic development, epidermal proliferation of the infundibulum of the hair follicle with occlusion of the pilosebaceous unit, or implantation of epidermal elements as a result of trauma or surgery along the incision lines. They can originate from hair follicles or invagination of surface epidermis. Some of these cysts occurring amongst the lashes will be difficult to distinguish from a blocked Zeiss gland (sebaceous gland). [4] Histopathologically, epidermoid cysts are characterized by an epithelial lining that does not possess intercellular bridges. The epithelial cells lose their nuclei and slough off into the lumen of the cyst. The lumen of the cyst usually contains predominantly homogenous, eosinophilic material and less keratin. Calcification occurs in 25% cases. The most common site for the sebaceous or epidermoid cysts is the  Meibomian gland More Detailss of the upper tarsus due to retention of meibomian gland material. These can also be present due to blockage of Zeiss glands near the eye lid margin. [5] In this case, it was an extrameibomian site, i.e. at the lateral superior aspect of the eyelid. It is a rare site for the epidermoid cyst to grow to such an extent. The treatment of choice is the excision of the cyst encapsulated with the cyst wall, as otherwise the cyst wall can lead to a recurrence of the cyst, and spillage of the cyst material in the surrounding tissue causes an inflammatory and a foreign body reaction.

 
  References Top

1.Braun-Falco O. Dermatology. 2 nd ed. Berlin, Germany: Springer; 2000. p. 1423-40.  Back to cited text no. 1
    
2.Shields JA, Bakewell B, Augsburger JJ, Donoso LA, Bernardino V. Space-occupying orbital masses in children. A review of 250 consecutive biopsies. Ophthalmology 1986;93:379-84.  Back to cited text no. 2
    
3.Kronish JW, Sneed SR, Tse DT. Epidermal cysts of the eyelid. Arch Ophthalmol 1988;106:270.  Back to cited text no. 3
    
4.David R. Jordan Common eye lid lumps and bumps. Insight 1997;3:1-2.  Back to cited text no. 4
    
5.Shields JA, Shields CL. Eyelid, Conjunctival, and Orbital Tumors: An Atlas and Textbook Lipppincott Williams and Wilkins; 2008. p. 198.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]


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