DOI: 10.36347/sjmcr.2016.v04i04.014

Pages: 228-230

Epidermoid cysts are slow growing, benign tumors that result from proliferation of epidermal cells within a confined space. Eyelid is one of the unusual locations for epidermoid cyst. Previously, they were often diagnosed as sebaceous cyst but they contain keratin, not sebaceous material. A 65 year old woman presented with a painless, right upper eyelid mass. The patient was aware of the lesion for the past 4 years, but it had been enlarging for the last 1 year, interfering with the superior field of vision. She denied a history of prior trauma, surgery, or eyelid inflammation. Examination revealed a firm, globular mass that was not mobile but fixed, resulting in mechanical ptosis. The patient underwent excisional biopsy through an upper eyelid incision. Histopathologic sections demonstrated a cyst lined by squamous epithelium containing laminated keratin consistent with a diagnosis of an epidermoid cyst. Intratarsal epidermal inclusion cysts share some clinical features with chalazia. Lack of inflammation lack of fluctuation in size, gradual continued slow growth, and delayed onset of recurrence may help to differentiate epidermoid cyst from recurrent chalazion. Incision and curettage, however, is not effective long-term treatment for this entity. Total excision of the cyst including full-thickness excision of tarsus at the cysts base of origin is suggested for definitive treatment.