Respiratory Epithelial Orbital Cyst: Report of a Case and Review of the Literature

Abstract

Orbital cysts include the common epidermoid and dermoid cysts, cysts of conjunctival origin and cysts lined by respiratory‐type epithelium. Respiratory epithelial cysts are exceedingly rare and have been reported in common locations for dermoid cysts (superotemporal and superonasal anterior orbit) and in sites atypical for dermoid cysts. Most represent maxillary sinus mucoceles extending into the orbital floor. In some patients, a history of orbital trauma or previous sinus surgery has been implicated in the implantation of the respiratory epithelium in the orbit. Rarely, the respiratory epithelial cyst has been considered to be a choristoma. We report the case of a 72‐year‐old woman who presented with a cyst in the anterior superotemporal orbit. There was no history of recent or remote trauma. The clinical impression was of a dermoid cyst. Histopathologic examination revealed a cyst lined by non‐keratinizing squamous epithelium. A few goblet cells were present and focally, short strips of ciliated mucin secreting columnar cells were identified. The histopathologic findings were those of a respiratory epithelial cyst of the orbit. Given the rarity of this entity, valuable information can be gleaned from critical evaluation and reporting of new cases, in the context of existing data in the literature.