Orbital inflammatory disease in a child caused by a ruptured dermoid cyst misdiagnosed as orbital cellulitis

Year 2021, , 348 - 350, 27.10.2021

Hayrunnisa Bekıs Bozkurt Hulya Gokmen Soysal

https://doi.org/10.5472/marumj.1013321

Abstract

One of the most common orbital tumors in childhood is orbital dermoid cysts. Cyst rupture or leakage of the cyst content is one of the
rare causes of orbital inflammations and needs to be caught early. A five and a half year old boy was referred to us with the diagnosis
of orbital cellulitis resistant to antibiotic therapy. Regarding his detailed medical history, physical examination and laboratory tests
findings, he was diagnosed as orbital inflammatory disease caused by dermoid cyst rupture. He underwent surgical excision of the
cyst after the inflammation was resolved with a short course of anti-inflammatory treatment. Although, it is rare, dermoid cyst
rupture is one of the important causes of orbital inflammatory diseases and it must be kept in mind in the differential diagnosis of
orbital infections. A detailed history and a careful examination helped us to make the correct diagnosis and avoided diagnostic delay
and unnecessary treatment.

Keywords

Inflammation, Dermoid cyst, Child, Orbital cellulitis

References

• [1] Belanger C, Zhang KS, Reddy AK, Yen MT, Yen KG. Inflammatory disorders of the orbit in childhood: a case series. Am J Ophthalmol 2010; 150:460-3. doi:10.1016/j. ajo.2010.05.012
• [2] Salchow DJ. Orbital disorders in childhood. Klin Monbl Augenheilkd 2019;236:1351-71. doi: 10.1055/a-0972-4774.
• [3] Reissis D, Pfaff MJ, Patel A, Steinbacher DM. Craniofacial dermoid cysts: histological analysis and inter-site comparison. Yale J Biol Med 2014; 87: 349-57.
• [4] Siah WF, Al-Muhaylib AA, Rajak S, Selva D, Malhotra R, Alsuhaibani AH. clinical outcomes of ruptured periorbital and orbital dermoid cysts. Ophthal Plast Reconstr Surg 2017; 33: 264-67
• [5] Lenci LT, Shams P, Shriver EM, Allen RC. Dermoid cysts: clinical predictors of complex lesions and surgical complications. JAAPOS. 2017; 21: 44-7.
• [6] Mombaerts I, Rose GE, Garrity JA. Orbital inflammation: Biopsy first. Surv Ophthalmol 2016; 61: 664-69.
• [7] Cruz AAV. Orbital inflammation and infection versus neoplasia. In: Karcioglu ZA, ed. Orbital Tumors: Diagnosis and Treatment. New York: Springer, 2005: 317-28.
• [8] Mouriaux F, Coffin-Pichonnet S, Robert PY, Abad S, Martin- Silva N Orbital inflammation. J Fr Orbital 2014; 37:818-24.
• [9] Williams KJ, Allen RC. Paediatric orbital and periorbital infections. Curr Opin Ophthalmol 2019 ;30:349-355.
• [10] Fasina O, Ogun OG. Giant deep orbital dermoid cyst presenting early in infancy in a Nigerian child: a case report and review of the literature. J Med Case Reports 2012; 6: 320. doi:10.1186/1752-1947-6-320
• [11] Siah WF, Al-Muhaylib AA, Rajak S. et al. Clinical outcomes of ruptured periorbital and orbital dermoid cysts. Ophthalmic Plastic & Reconstructive Surgery 2017; 33: 264-7. doi: 10.1097/ IOP.000.000.0000000735
• [12] Cavazza S, Laffi GL, Lodi L, Gasparrini E, Tassinari G. Orbital dermoid cyst of childhood: clinical pathologic findings, classification and management. Int Ophthalmol 2011;31:93-7. doi: 10.1007/s10792.011.9419-y