A Case of a Cyst Containing a Parasite and Misdiagnosed as a Dermoid Cyst

PURPOSE: To introduce a case of a cyst containing a parasite misdiagnosed as a dermoid cyst, which is to the best of our knowledge, the first report in Korea of a parasite in a cyst located at the medial side of the orbit. CASE SUMMARY: A 31-year-old male visited the hospital with a 2-year history of a slowly growing mass at the medial side of the right orbit. The patient had a history of mass excision in the same location 18 years previously, however, biopsy was not performed at that time. Orbital computed tomography and magnetic resonance imaging revealed a 5.0 × 1.4 × 1.8 cm³ well-defined T1 high signal intensity unilocular cyst, thus our first impression was a dermoid cyst. The cyst was surgically removed with anterior orbitotomy. The cyst ruptured during the operation, and thus complete aspiration of the cystic fluid and in situ irrigation with antibiotics were performed. Histopathological examination revealed a fragmented adult parasite worm with chronic granulomatous change. CONCLUSIONS: A differential diagnosis for orbital cyst based on clinical and radiological results is difficult. Thus, histopathological confirmation is required. A cyst containing a parasite located in the orbit has rarely been reported. A full examination of all infected patients must be conducted for parasite infection.

A Case of Conjunctival Dermoid Cyst of the Orbit

PURPOSE: To report a case of primary conjunctival dermoid of the superonasal orbit. CASE SUMMARY: A 41-year-old man complained of swelling of the left lower eyelid and left periocular pain for a week. Examination revealed 3 mm of proptosis with superotemporal displacement of the left eye. Orbital CT revealed a 32x27x33-mm well-defined giant cyst with a fat-fluid level in the superonasal aspect of the left orbit. Orbital MRI showed bone remodeling around the cyst, consistent with a dermoid cyst. The cyst was approached via lateral orbitotomy and transcaruncular incision but was ruptured just prior to the end of the dissection and was totally excised using a cryoprobe to freeze the ruptured site. Upon histopathological examination, the cyst was misdiagnosed as a conjunctival cyst because there was no dermal appendage but was rediagnosed as a conjunctival dermoid cyst after the tissue sample was examined more thoroughly. After surgery, the patient presented with diplopia due to esodeviation and was prescribed prismatic lenses.

Hydatid Cyst of the Orbit

PURPOSE: Most hydatid cysts affecting humans grow in the liver and the lung, but orbital involvement is very rare. To our knowledge, this is the first report of a hydatid cyst of the orbit in Korea. METHODS: A 33-year-old woman came to the hospital with a 2-month history of slowly progressive proptosis and ocular pain of the right eye. The right eye showed proptosis, visual impairment and mild limitation of abduction. Orbital CT and MRI revealed a 32X20X24-mm well-defined unilocular cyst in the retrobulbar, intraconal area of the right orbit. RESULTS: The cyst was surgically removed with lateral orbitotomy and it ruptured just prior to the end of the operation. Complete aspiration of the cystic fluid and in situ irrigation with gentamicin-normal saline mixture were performed. Histopathological examination revealed a hydatid cyst. After surgery, the visual acuity and primary position of the right eye were recovered, but its abduction was mildly limited.

Orbital Cyst after Repair of Blow-out Fracture

When blow-out fracture repair is performed, many implants including Silastic, Supramid, Porous polyethylene and others have been used to pervent reherniation of orbital tissue. Complications associated with implants include implant extrusion, orbital infection, fistula formation, implant migration, extraocular muscle entrapment, globe elevation, protosis and orbital cyst formation. The latter was known as a rare late complication of blow-out fracture repair. We report two cases of orbital cyst which developed after blow-out fracture repair with alloplastic implants. These patients developed diplopia and unliateral proptosis 7 and 10 years after repair of blow-out fracture, respectively. In these cases, orbital CT scan revealed retrobulbar cyst-like structures surrounding the orbital implant. At sufgery, a fibrous capsule surrounded the previously inserted orbital implants and was filled with dark brown mucoid material in both cases. These cysts were lined by squamous epithelium with cholesterol cleft and hemosiderin laden macrophage collection. Proptosis and diplopia were resolved after surgical removal of the cyst. These cases illustrate that it is important for us to be aware of the complication of late cyst formation around alloplastic implants after repair of blow-out fracture.

Microphthalmos with cyst: case presentation

The author has experienced a case of microphthalmos with large orbital cyst in a 4 months old female, that was found at the time of birth. To facilitate fitting a cosmetic prosthesis, the microphthalmos with cyst was removed surgically. On serial section I could find an area of discontinuation of the sclera that was suspected to be the defective closure of the embryonic cleft. Some aberrant retinal tissue was found in the wall of the cyst, and markedly disorganized ocular tissue forming a tumor-like mass filled the microphthalmic eyeball. In view of these histopathologic findings I could draw the conclusion that developmental failure of the embryonic eyeball and consequential proliferation of the embryonic neuroepithelial cells occurred at an early developmental stage causing the formation of microphthalmos with cyst.

Microphthalmia with Orbital Cyst: Case Presentation

A microphthalmia with orbital cyst resulting from a failure in the involution of primary optic vesicle or defective closure of embryonic cleft is rare congenital anomaly. Clinical features are variable and mainly depend upon the time of arrest in development of the embryonic eyeball The authors have experienced a case of microphthamia with1uge orbital cyst in left orbit. The patient was 4 months of age and it was found at the time of birth. At radiologic study an area of suspicious defect in the orbital roof was shown. The orbital cyst and small eyeball were removed by intracranial approach and histopathologic examination was performed with serial section. We could find a suspicous site of defective closure of embryonic cleft and also ectopic retinal tissue in the cystic wall. A disorganized ocular tissues forming tumor like mass filled with microphthalmic eyeball. No cornea, iris or anterior chamber was found in the slide. In view of those histopathologic findings we can suspect that the defective closure of embryonic cleft occured at 7 to 14 mm embryo stage.