Dermoid Cyst of the Orbit and Frontal Sinus: A Case Report

Abstract

We describe a case of a dermoid cyst involving the orbit and frontal sinus of an adult treated at our tertiary referral center, and we review the literature on dermoid cysts of the orbit and frontal sinus. A 28-year-old Caucasian man presented with right-sided supraorbital swelling resulting in diplopia and reduced visual acuity. Computed tomography and magnetic resonance imaging scans were preformed. Although a definitive diagnosis was unclear, the imaging findings were consistent with a dermoid cyst. The lesion was excised through an upper-lid incision. Postoperatively, the patient had a patent frontal sinus and his visual symptoms resolved. Dermoid cysts of the orbit are uncommon lesions that occur primarily in the pediatric population. Lesions extending into the frontal sinus have not been reported before in the literature. In adults, orbital dermoids are more likely to present with bone erosion, and therefore they should be considered in the differential diagnosis for orbital and frontal bone lesions extending into the frontal sinus.

Nasal Dermoid Sinus Cyst expanding into Frontal Sinus: A Rare Presentation

“…Another case of dermoid cyst arising from the medial part of orbit extending into the frontal sinus was reported which was excised by external incision in the frontal sinus floor. 3 Two intracranial nasal dermoid excised endoscopically were reported by Schuster et al 10 recently but were not involving the frontal sinus. In general, these lesions are present in childhood.…”

“…2 Dermoid cysts occur in three primary locations in the head and neck: The frontotemporal region, the periorbital region and the nasoglabellar region. 3 They are congenital lesions lined by stratified squamous epithelium, with normal dermal appendages, including hairs and sebaceous glands. The differential diagnosis needs to be carefully considered during assessment and includes ectopic neuroglia, encephaloceles and teratomas.…”

Dermoid Cyst of the Frontal Bone: A Case Report

“…In general, these lesions present in childhood. When they occur deep within the orbit, they may escape diagnosis until adulthood when they present with ophthalmologic symptoms as well as erosion of nearby bony tissues [9].…”

Combined minimally invasive surgical management of a nasal dermoid sinus cyst affecting the frontal sinus: literature review and new classification.

“…This is primarily due to the presence of characteristic signs and symptoms (e.g., external nose deformation or pathognomonic hair concentration protruding from the sinus canal on the skin above the lesion, often accompanied by periodic ‘cheesy’-like sebaceous and keratin discharge) [ 10 , 11 , 13 , 18 ]. NDSCs diagnosed in adulthood are rare, with only two published cases involving the frontal sinus [ 4 , 19 – 22 ].…”

“…Approximately 39% to 84% of head and neck dermoid cysts are located in the periorbital region [ 5 , 6 , 22 , 23 ], most of which are localized in the superior temporal zygomatico-frontal suture, and about 10% are localized in the superior nasal frontal suture [ 24 ]. NDSCs with an orbital extension are also described in the literature [ 22 , 25 ] and their symptoms include swelling in the periorbital region with deteriorating vision and eye displacement (i.e., proptosis, ptosis or diplopia) [ 19 , 20 , 22 ]. Additionally, since limited forehead or upper eyelid swelling may occur, complications of frontal sinusitis should be taken into consideration during the differential diagnosis, especially when patients do not respond to standard treatment [ 4 , 19 – 22 , 26 ].…”