The spectrum of orbital dermoid cysts and their surgical management

Bajric, Jasmina; Harris, Gerald J.

doi:10.1080/01676830.2019.1631357

Cited by 10 publications

(18 citation statements)

References 30 publications

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“…Intradiplopic orbital dermoid and epidermoid cysts are rare, benign tumors, with only 49 cases reported in the literature. [ 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 ] Orbital dermoid cysts are far more common and are most often periocular, with several large series reporting over 80% presenting as a subcutaneous mass. [ 1 52 ] Deep orbital dermoid cysts, also referred to as endophytic cysts, have also been reported, and are more often present later in life with orbital inflammation.…”

Section: Discussionmentioning

confidence: 99%

Differentiating intradiploic orbital dermoid and epidermoid cysts utilizing clinical features and machine learning

Tooley

Tailor²,

Tran³

et al. 2022

Indian Journal of Ophthalmology

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Purpose: The purpose of this study was to characterize intradiploic dermoid and epidermoid orbital cysts to determine any differences in clinical, radiographic, or surgical features. Methods: A retrospective review was performed of patients presenting with intradiplopic dermoid or epidermoid cysts. Additionally, a complete review of the literature was performed to identify cases of intradiplopic orbital dermoid and epidermoid cysts. Data collected included age, sex, presenting symptoms, location of intradiplopic cyst, ophthalmic findings, treatment, and follow-up. Clinical features of dermoid versus epidermoid cyst were compared. Additionally, machine-learning algorithms were developed to predict histopathology based on clinical features. Results: There were 55 cases of orbital intradiploic cysts, 49 from literature review and six from our cohort. Approximately 31% had dermoid and 69% had epidermoid histopathology. Average age of patients with dermoid cysts was significantly lesser than that of patients with epidermoid cysts (23 vs. 35 years, respectively; P = 0.048). There was no difference between sex predilection, presenting symptoms, radiographic findings, or surgical treatment of dermoids and epidermoids. The majority of patients (64%) underwent craniotomy for surgical removal. Machine-learning algorithms KStar and Neural Network were able to distinguish dermoid from epidermoid with accuracies of 76.3% and 69%, respectively. Conclusion: Orbital intradiploic cysts are more commonly epidermoid in origin. Dermoid cysts presented in younger patients; however, there were no other significant differences in features including ophthalmic or radiographic findings. Despite similar features, machine learning was able to identify dermoid versus epidermoid with good accuracy. Future studies may examine the role of machine learning for clinical guidance as well as new surgical options for intervention.

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Section: Discussionmentioning

confidence: 99%

Differentiating intradiploic orbital dermoid and epidermoid cysts utilizing clinical features and machine learning

Tooley

Tailor²,

Tran³

et al. 2022

Indian Journal of Ophthalmology

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“…The majority of the lateral intraorbital DC have bony involvement, so it is essential to understand the relationship between the cyst and bone in surgical planning. In these cases, all epidermal elements of the cyst must be removed, and burring of the bone may be necessary [ 7 ]. We present five cases of a rare intraosseous location of a DC treated using an incision and curettage approach.…”

Section: Discussionmentioning

confidence: 99%

“…When DC involves the ocular adnexa or orbit, the presenting signs and symptoms findings are commonly nonspecific and may be confusing, especially in adulthood [ 1 , 7 ]. Therefore, radiological evaluation with and without histological evaluation is essential in making the exact diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Atypical intraorbital dermoid and epidermoid cyst: A single institution cross-sectional retrospective study

Eshraghi

Shahsanaei²,

Abounoori³

et al. 2022

Annals of Medicine &Amp; Surgery

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“…It is widely documented that epithelial desquamation and accumulation of glandular secretions causes slow enlargement of dermoid cysts, 2,3 and that lipid seepage from unoperated cysts causes chronic inflammation and foreign-body giant-cell granulomas. 2,3,6,7 Intramural and pericystic inflammation is common, even in childhood, 2,5 and pericystic lesions within the surrounding fat have been termed 'satellite inflammatory pseudocysts'. 3 Inadvertent intra-operative rupture of dermoids occurs in 10-28% of cases 1,5,8 and deep orbital or intraosseous dermoids, being larger or multiloculated, generally need piecemeal removal.…”

Section: Discussionmentioning

confidence: 99%

“…In the absence of infection, inflammation after excision of a dermoid cyst will arise from the response to necrotic tissues or to extracellular lipid outside the cyst lumen. Whilst the clinical and histopathological features for spontaneous lipid leakage from the cyst lumen --causing chronic, often granulomatous, inflammation within the cyst wall and neighboring tissues --is very well recognized and widely reported, [1][2][3][4][5] there does not appear to be any description of the pathological changes of persistent inflammation after excision of deep orbital dermoids and in the absence of any residual epithelium. Deep orbital dermoid cysts often occupy multiple cavities within the orbit and surrounding bones, making intact excision very unusual.…”

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confidence: 99%

Persistent orbital inflammation following complete excision of deep dermoid cysts

Wilde¹,

Vahdani

Rose

2022

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Piecemeal excision of dermoid cysts carries the risk of implanting epithelial fragments into orbital fat, which is well-recognized to continue secreting oily debris, inciting chronic, often granulomatous inflammation. The authors present the clinical and histological details for two patients with persistent lipogranulomatous inflammation for years after piecemeal excision of deep orbital dermoid cysts, in the absence of any residual epithelium. The importance of copious saline lavage --to 'float-out" and reduce microscopic lipid droplets is also emphasised.

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The spectrum of orbital dermoid cysts and their surgical management

Cited by 10 publications

References 30 publications

Differentiating intradiploic orbital dermoid and epidermoid cysts utilizing clinical features and machine learning

Differentiating intradiploic orbital dermoid and epidermoid cysts utilizing clinical features and machine learning

Atypical intraorbital dermoid and epidermoid cyst: A single institution cross-sectional retrospective study

Persistent orbital inflammation following complete excision of deep dermoid cysts

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