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Orbital Dermoid and Epidermoid
Surjith Vattoth, MD, FRCR; H. Christian Davidson, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Congenital orbital ectodermal inclusion cyst
                • Dermoid = epidermal dermoid cyst
                • Epidermoid = epidermal or epithelial cyst
              • Definitions

                • Cystic, choristomatous mass lesion of orbit resulting from congenital epithelial inclusion
                  • Choristoma = tumor composed of tissue that is histologically normal but located in abnormal site
                • Dermoid lesions
                  • Epithelial elements plus dermal substructure, including dermal appendages
                • Epidermoid lesions
                  • Epithelial elements without adnexal structures

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Lee BG et al: Intradiploic epidermoid cyst of the orbital roof: a case report. Orbit. 1-3, 2018
                                              2. Purohit BS et al: Orbital tumours and tumour-like lesions: exploring the armamentarium of multiparametric imaging. Insights Imaging. 7(1):43-68, 2016
                                              3. Burnham JM et al: Intracranial extension of an orbital epidermoid cyst. Ophthal Plast Reconstr Surg., 2014
                                              4. Fanous AA et al: Analysis of the growth pattern of a dermoid cyst. J Neurosurg Pediatr. 14(6):621-5, 2014
                                              5. Ormond DR et al: Uncommon presentation of an intradiploic orbital epidermoid tumor: case report. Oral Maxillofac Surg. 15(3):165-7, 2011
                                              6. Lope LA et al: Magnetic resonance imaging in the analysis of pediatric orbital tumors: utility of diffusion-weighted imaging. J AAPOS. 14(3):257-62, 2010
                                              7. Yeola M et al: Orbital floor dermoid: an unusual presentation. Indian J Ophthalmol. 57(1):51-2, 2009
                                              8. Kudo K et al: Orbital dermoid cyst with intratumoral inflammatory hemorrhage: case report. Neurol Med Chir (Tokyo). 48(8):359-62, 2008
                                              9. Golden RP et al: Percutaneous drainage and ablation of orbital dermoid cysts. J AAPOS. 11(5):438-42, 2007
                                              10. Yen KG et al: Current trends in the surgical management of orbital dermoid cysts among pediatric ophthalmologists. J Pediatr Ophthalmol Strabismus. 43(6):337-40; quiz 363-4, 2006
                                              11. Shields JA et al: Orbital cysts of childhood--classification, clinical features, and management. Surv Ophthalmol. 49(3):281-99, 2004
                                              12. Chawda SJ et al: Computed tomography of orbital dermoids: a 20-year review. Clin Radiol. 54(12):821-5, 1999
                                              13. Meyer DR et al: Primary temporal fossa dermoid cysts. Characterization and surgical management. Ophthalmology. 106(2):342-9, 1999
                                              14. Shields JA et al: Orbital dermoid cysts: clinicopathologic correlations, classification, and management. The 1997 Josephine E. Schueler Lecture. Ophthal Plast Reconstr Surg. 13(4):265-76, 1997
                                              15. Bartlett SP et al: The surgical management of orbitofacial dermoids in the pediatric patient. Plast Reconstr Surg. 91(7):1208-15, 1993
                                              16. Lane CM et al: Orbital dermoid cyst. Eye. 1 ( Pt 4):504-11, 1987
                                              17. Nugent RA et al: Orbital dermoids: features on CT. Radiology. 165(2):475-8, 1987
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Congenital orbital ectodermal inclusion cyst
                                                            • Dermoid = epidermal dermoid cyst
                                                            • Epidermoid = epidermal or epithelial cyst
                                                          • Definitions

                                                            • Cystic, choristomatous mass lesion of orbit resulting from congenital epithelial inclusion
                                                              • Choristoma = tumor composed of tissue that is histologically normal but located in abnormal site
                                                            • Dermoid lesions
                                                              • Epithelial elements plus dermal substructure, including dermal appendages
                                                            • Epidermoid lesions
                                                              • Epithelial elements without adnexal structures

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Ultrasonographic Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Lee BG et al: Intradiploic epidermoid cyst of the orbital roof: a case report. Orbit. 1-3, 2018
                                                                                          2. Purohit BS et al: Orbital tumours and tumour-like lesions: exploring the armamentarium of multiparametric imaging. Insights Imaging. 7(1):43-68, 2016
                                                                                          3. Burnham JM et al: Intracranial extension of an orbital epidermoid cyst. Ophthal Plast Reconstr Surg., 2014
                                                                                          4. Fanous AA et al: Analysis of the growth pattern of a dermoid cyst. J Neurosurg Pediatr. 14(6):621-5, 2014
                                                                                          5. Ormond DR et al: Uncommon presentation of an intradiploic orbital epidermoid tumor: case report. Oral Maxillofac Surg. 15(3):165-7, 2011
                                                                                          6. Lope LA et al: Magnetic resonance imaging in the analysis of pediatric orbital tumors: utility of diffusion-weighted imaging. J AAPOS. 14(3):257-62, 2010
                                                                                          7. Yeola M et al: Orbital floor dermoid: an unusual presentation. Indian J Ophthalmol. 57(1):51-2, 2009
                                                                                          8. Kudo K et al: Orbital dermoid cyst with intratumoral inflammatory hemorrhage: case report. Neurol Med Chir (Tokyo). 48(8):359-62, 2008
                                                                                          9. Golden RP et al: Percutaneous drainage and ablation of orbital dermoid cysts. J AAPOS. 11(5):438-42, 2007
                                                                                          10. Yen KG et al: Current trends in the surgical management of orbital dermoid cysts among pediatric ophthalmologists. J Pediatr Ophthalmol Strabismus. 43(6):337-40; quiz 363-4, 2006
                                                                                          11. Shields JA et al: Orbital cysts of childhood--classification, clinical features, and management. Surv Ophthalmol. 49(3):281-99, 2004
                                                                                          12. Chawda SJ et al: Computed tomography of orbital dermoids: a 20-year review. Clin Radiol. 54(12):821-5, 1999
                                                                                          13. Meyer DR et al: Primary temporal fossa dermoid cysts. Characterization and surgical management. Ophthalmology. 106(2):342-9, 1999
                                                                                          14. Shields JA et al: Orbital dermoid cysts: clinicopathologic correlations, classification, and management. The 1997 Josephine E. Schueler Lecture. Ophthal Plast Reconstr Surg. 13(4):265-76, 1997
                                                                                          15. Bartlett SP et al: The surgical management of orbitofacial dermoids in the pediatric patient. Plast Reconstr Surg. 91(7):1208-15, 1993
                                                                                          16. Lane CM et al: Orbital dermoid cyst. Eye. 1 ( Pt 4):504-11, 1987
                                                                                          17. Nugent RA et al: Orbital dermoids: features on CT. Radiology. 165(2):475-8, 1987