title: Unsuspected Conjunctival Orbital Dermoid Cyst: Aids in Diagnosis.
abstract: A 25-year-old man with Type 1 diabetes mellitus experienced rapid visual decline and was scheduled for right cataract surgery. At the time of administering an inferotemporal retrobulbar block, a white discharge appeared spontaneously on the surface of the globe. Superotemporally a cyst was found and its contents were subtotally evacuated. Microscopically, eosinophilic, acellular material with chatter artifact and small vacuoles was detected and initially thought to represent a lens choristoma. This material stained moderately with the periodic acid Schiff method and was focally Congo red positive without apple green birefringence; it also stained blue with the Masson trichrome method. Acid-fast staining disclosed the presence of rare vellous hairs. Adherent cells were not epidermal cells (CK5/6) but conjunctival epithelial cells (CK7); CD68-positive histiocytes were also identified. The lesion was diagnosed as a disrupted orbital dermoid cyst of conjunctival origin.
authors.affiliation: David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Jakobiec
authors.forename: Fouad R
authors.initials: FR
authors.lastname: Zakka
authors.forename: Alice
authors.initials: A
authors.lastname: Lorch
mesh_terms: D000328:Adult; D001706:Biopsy; D003228:Conjunctiva / Q000473:pathology*; D003230:Conjunctival Neoplasms / Q000175:diagnosis*; D003884:Dermoid Cyst / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D009918:Orbital Neoplasms / Q000175:diagnosis*