Abstract
Purpose
Epidermoid tumors are uncommon entities that usually occur intradurally in the cerebellopontine angle and parasellar cisterns. The few cases that have been reported to occur in the intraorbital location involve patients in the first four decades of life. To our knowledge, an elderly person presenting with an orbital epidermoid tumor has never been reported.
Methods
A 67-year-old man presented with left-sided headache and eye pain. He was found to have a hemorrhagic lesion eroding bone of the greater and lesser wings of the sphenoid that was compressing the frontal and temporal lobes and displacing the globe. Significant edema of the frontal lobe was noted.
Results
Aggressive surgical excision was performed with cranioplasty and orbital reconstruction. Near resolution of the patient’s proptosis and eye pain was achieved. Histologic analysis revealed the lesion to be an epidermoid tumor.
Conclusions
Hemorrhage into a growing intradiploic orbital epidermoid and surrounding frontal lobe edema created an unusual presentation of this rarely occurring entity in an elderly man. Surgical excision allowed appropriate histologic diagnosis and resolution of symptoms. Epidermoid tumor is a rare but possible entity in the differential diagnosis of elderly patients presenting with acute ocular pain and proptosis.
This is a preview of subscription content, log in via an institution to check access.
References
Blanco G, Esteban R, Galarreta D et al (2001) Orbital intradiploic giant epidermoid cyst. Arch Ophthalmol 119:771
Keene JR, Hillard VH, Murali R, Geldzahler G (2005) Intraorbital epidermoid tumors: a case report and a review of the literature. J Oral Maxillofac Surg 63:1674–1676
Bertal A, Hilmani S, Chrifi Alaoui S et al (2007) Orbital epidermoid cyst. Case report. Neurochirurgie 53:364–366
Arseni C, Danaila L, Constantinescu A (1975) Cranial and orbital epidermoid tumours. J Neurosurg Sci 19:139–151
Arana E, Latorre FF, Revert A et al (1996) Intradiploic epidermoid cysts. Neuroradiology 98:1737–1743
Baxter JW, Netsky MG, Osborne DR et al (1985) Epidermoid and dermoid tumors. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 655–673
Dutt SN (2002) Radiologic differentiation of intracranial epidermoids from arachnoid cysts. Otol Neurol 23:84
Park WC, White WA, Woog JJ et al (2006) The role of high-resolution computed tomography and magnetic resonance imaging in the evaluation of isolated orbital neurofibromas. Am J Ophthalmol 142:456–463
Jung WS, Ahn KJ, Park MR et al (2007) The radiological spectrum of orbital pathologies that involve the lacrimal gland and the lacrimal fossa. Korean J Radiol 8:336–342
Iranmanesh R, Lillehei KO, Durairaj VD (2006) Giant epidermoid cyst as an unusual presentation of hypoglobus and ptosis. Ophthal Plast Reconstr Surg 22:221–222
Eijpe AA, Koorneef L, Verbeeten B et al (1991) Intradiploic epidermoid cysts of the bony orbit. Ophthalmology 98:1737
Meyer DR, Lessner AM, Yeatts RB et al (1999) Primary temporal fossa dermoid cysts: characterization and management. Ophthalmology 106:342
Bretschneider T (1999) Squamous cell carcinoma arising in an intradiploic epidermoid cyst. Neuroradiology 41:570
Holds JB, Anderson RL, Mamalis N et al (1993) Invasive squamous cell carcinoma rising from asymptomatic choristomatic cysts of the orbit. Ophthalmology 100:1244
Disclosures
The authors have no disclosures.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ormond, D.R., Omeis, I. & Abrahams, J. Uncommon presentation of an intradiploic orbital epidermoid tumor: case report. Oral Maxillofac Surg 15, 165–167 (2011). https://doi.org/10.1007/s10006-010-0232-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10006-010-0232-y