DR. VARSHA BACKIAVATHY T.

Abstract

Dermoid cysts are benign congenital choristomas. They are commonly located in the superotemporal and superonasal quadrants corresponding to the frontozygomatic and frontoethmoidal suture lines respectively. Here we present a dermoid cyst in an unusual location mimicking an encysted mucocele. A young female presented with a swelling in the right medial canthal area for six months. On cursory examination it clinically appeared to be an encysted mucocele due to its typical location and absence of regurgitation on pressure over the lacrimal sac. In view of the syringing being freely patent, a different pathology was suspected. Imaging revealed an oval well defined soft tissue lesion within the lacrimal fossa compressing the lacrimal sac with free flow of contrast through the nasolacrimal duct. An excisional biopsy confirmed the diagnosis to be a dermoid. This case displays the need for a detailed preoperative assessment and high index of suspicion for a successful outcome.