- Author: Anna G Gushchin, MD; Chief Editor: Hampton Roy, Sr, MD more...
Dermoid and epidermoid cysts are examples of choristomas, tumors that originate from aberrant ectodermal tissue. These tumors contain normal-appearing tissue in an abnormal location. As two suture lines of the skull close during embryonic development, dermal or epidermal elements may be pinched off and form cysts, which are adjacent to the suture line (this is shown in the image below). Approximately 50% of dermoids that involve the head are found in or adjacent to the orbit.
Orbital dermoid cysts may displace structures in the orbit, causing proptosis, motility abnormalities, or optic nerve compression. Significant displacement may interfere with vision by compression of the optic nerve or disturb ocular motility, resulting in diplopia. Rupture of the dermoid, either spontaneously or with a trauma, may lead to an intense inflammatory reaction that could mimic orbital cellulitis.
At an ocular oncology center, dermoid tumors were found to comprise 2% of the orbital tumors that came to surgery. Shields et al reported that dermoid cysts comprised of 24% of 645 consecutive orbital biopsies among all age groups and 46% of 250 consecutive biopsies in patients younger than 18 years.[2, 3]
Orbital dermoid cysts almost never cause death.
Morbidity is usually of a cosmetic nature; occasionally, loss of vision, diplopia, or orbital inflammation may occur.
Dermoid tumors show no racial predilection.
Dermoid tumors have an equal incidence in males and females.
These tumors are most often noted in young children; however, they may appear or grow at any age.
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