Abstract
IntroductionDermoid cysts are the most common orbital cystic lesions seen in children. While superficial orbital dermoid cysts present early in life, deep dermoid cysts remain clinically occult until adolescence or adulthood. We here present a case of a deep orbital dermoid cyst in a Nigerian child that became symptomatic early in infancy.Case presentationA female Nigerian infant of Yoruba ethnicity presented at three months of age with left non-axial proptosis and a hazy cornea. A superotemporal cystic orbital mass was seen on ultrasonography, and her parents were counseled for simple tumor excision. They however defaulted, only for their child to re-present two years later with gradually progressive proptosis, an enlarged orbit and keratinized ocular surface, necessitating orbital exenteration.ConclusionDeep orbital dermoid cysts may be symptomatic from birth. Late presentation may result in an irreversible loss of vision, as demonstrated in our case. The need for public enlightenment on early presentation and prompt management of such benign lesions is emphasized.
Highlights
Dermoid cysts are the most common orbital cystic lesions seen in children
Deep orbital dermoid cysts may be symptomatic from birth
Dermoid cysts are congenital, benign, cystic teratomas [1], described as developmental cystic lesions derived from inclusion of ectodermal elements during the closure of the neural tube adjacent to fetal suture lines [2]
Summary
Reported dermoid cysts in our environment [6,7] formed part of a series of orbito-ocular lesions and were superficial. We present an unusual case of a deep orbital dermoid cyst in a child. There is an urgent need to educate the medical staff and general populace on these benign childhood orbital conditions and their uncommon presentation. Parents should be encouraged to present their children early to health facilities for treatment of this benign condition. This could have led to the preservation of visual function in our patient, and may preserve life in other potentially life-threatening conditions. 6. Bekibele CO, Oluwanisola AO: A clinicopathological study of orbito-ocular diseases in Ibadan between 1991–1999.
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