A 5-year-old boy presents with a superotemporal orbital mass present since birth, which transiently increased in size with upper respiratory infection. CT shows an extraconal cystic lesion with fat-density contents at the fronto-zygomatic suture. The diagnosis is:

• A Lacrimal gland adenoma
• B Lymphatic malformation (lymphangioma)
• C Capillary haemangioma
• D Orbital dermoid cyst ✓

Explanation

Orbital dermoid cysts are the most common benign orbital tumours in children, arising from epithelial rests along suture lines (most commonly fronto-zygomatic). CT shows a cystic lesion containing fat with a rim-enhancing wall at the suture. They may enlarge acutely during inflammation. Lymphatic malformations enlarge with URTIs due to lymphoid hyperplasia but appear as multiloculated cysts without fat. Capillary haemangiomas appear in the first weeks of life and enhance brightly.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.