Subconjunctival Lipogranuloma with Orbital Dermoid Cyst.

Choi, Sang Il; Kim, Yoon Duck

Original Article

Journal of the Korean Ophthalmological Society 2002;43(8):1536-1540.
Published online August 1, 2002.

Subconjunctival Lipogranuloma with Orbital Dermoid Cyst.

Department of Ophthalmology, Samsung Medical Center , College of Medicine, Sungkyunkwan University, Seoul, Korea. ydkim@smc.samsung.co.kr

안와 유피낭으로 인한 결막하 지방육아종

최상일 ( Sang Il Choi ) , 김윤덕 ( Yoon Duck Kim )

Abstract

PURPOSE
Orbital dermoid cyst develops from the sequestrated ectoderm in bony suture line during embryogenesis. It often presents inflammatory symptoms due to rupture of the cyst, proptosis, diplopia, ptosis, visual acuity impairment, lacrimation, and so on. We report a case of subconjunctival lipogranuloma due to rupture of the orbital dermoid cyst. METHODS: A 39-year-old female patient visited a local eye clinic with conjunctival injection and conjunctival irritation suddenly occurred about 1 month before. Her subconjunctival injection and irritating symptom did not improve although she had been treated with topical steroid and antibiotics eye drops for 1 month. Orbit CT revealed cystic mass of orbit and referred to our oculoplastic clinic. On eye examination, conjunctival injection, numerous subconjunctival small yellow granules and 2 mm of proptosis were observed in the left eye. The CT scan of the orbit showed 2x2.3x1.5 cm-sized cystic mass in superotemporal region of the left orbit. The cyst showed the content with low attenuation and calcification in the cystic wall. The cystic mass was removed with lateral orbitotomy and conjunctival biopsy was performed. RESULTS: Microscopic diagnosis of the cystic mass was dermoid cyst with foreign body reaction and lipogranuloma due to rupture of the cyst. The microscopic examination of the conjunctiva showed lipid vacuoles and chronic inflammatory cells infiltrated into the stroma compatible with the findings of lipogranuloma. CONCLUSIONS: We report a very unusual case of subconjunctival lipogranuloma due to rupture of the orbital dermoid cyst.

Key Words: Dermoid cyst;Lipogranuloma