J Korean Ophthalmol Soc.  2010 Jun;51(6):885-889. 10.3341/jkos.2010.51.6.885.

Primary Conjunctival Epithelial Cyst in the Orbit

• Yi CH
• Sung MS
• Kim HG
• Woo KI
• Kim YD

• KMID: 2213625
• DOI: http://doi.org/10.3341/jkos.2010.51.6.885

Abstract

PURPOSE
To report a case of a primary conjunctival epithelial cyst in the orbit.
CASE SUMMARY
A 60-year-old woman was referred for evaluation of proptosis of the left eye, which had developed about 2 years earlier. Upon initial examination, a movable mass was palpated in the medial aspect of the left orbit. Magnetic resonance imaging of the orbit showed a 2.5 cm-sized, ovoid, cystic mass located between the left eyeball and the medial wall of the orbit. Excisional biopsy of the orbital mass was performed. The orbital mass was a well-circumscribed cystic lesion, adherent to the medial rectus muscle. Histological examination revealed that the cyst was lined with multiple layers of cuboidal epithelium with goblet cells. A diagnosis of primary conjunctival cyst was made.
CONCLUSIONS
The possibility of primary conjunctival cyst should be considered in the differential diagnosis for an orbital cystic mass.

Keyword

Conjunctival epithelial cyst; Orbit

MeSH Terms

Biopsy
Diagnosis, Differential
Epithelium
Exophthalmos
Eye
Female
Goblet Cells
Humans
Magnetic Resonance Imaging
Middle Aged
Muscles
Orbit

Figure

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  Figure 1. Clinical photograph showing movable mass in the inferonasal part of the left orbit (arrows).

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  Figure 2. Axial (A) and coronal (B) CT images reveal a 2.5×2.4×1.4-cm, ovoid, cystic mass in the medial aspect of the left orbit. Lateral displacement of the left globe and pressure remodeling of the medial wall in the left orbit are shown.

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  Figure 3. Axial (A) T1-weighted MR image and coronal (B) T2-weighted MR image demonstrate a well-circum-scribed cystic lesion between the eyeball and medial wall in the left orbit. Axial (C) and sagittal (D) fat-sup-pressed contrast-enhanced T1-weighted MR images show the cystic mass which is adherent to medial rectus muscle without enhancement.

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  Figure 4. Intraoperative photograph showing a thin-walled, well-circumscribed cyst.

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  Figure 5. (A) The cystic wall is lined with nonkeratinized, cuboidal, or columnar epithelium with goblet cells (H & E stain, ×100). (B) Higher magnification showed stratified cuboidal or columnar epithelial cells and goblet cells (arrows) (H & E stain, ×400).

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  Figure 6. Immunohistochemistry for smooth muscle actin (SMA) demonstrated bundles of smooth muscle cells, surrounding the cyst incompletely (immunohistochemical staining using SMA, ×100).

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  Figure 7. Postoperative photograph showing a left esotropia of 6 prism diopters (PD) in the primary position at 2 months after surgery.

Reference

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