Bilateral Dermoid Cysts on the Lateral Ends of Eyebrows

Dermoid cysts are a type of benign periorbital tumor that is frequently encountered in children. According to New and Erich, dermoid cysts originate from dermal and epidermal inclusions along the embryonic cleft closure lines located in the head and neck [1]. Periorbital involvement accounts for more than 50% of the pediatric cases of these cysts. Periorbital dermoid cysts usually manifest as painless, slow-growing swellings on the lateral eyebrows. Sometimes, they can cause inflammation and have a mass effect on the adjacent tissue or bone. Unilateral dermoid cysts on the lateral ends of eyebrows are common, but bilateral dermoid cysts are very rare and only one case has been reported thus far [2]. Here, we report a case of bilateral dermoid cysts on the lateral ends of the eyebrows. A 13-year-old child visited our clinic for an evaluation of masses on both eyebrows (Fig. 1). According to the medical history obtained from his parents, the masses were palpable from birth and had been growing very slowly. The patient was otherwise asymptomatic and did not have any visual compromise. Each mass was cystic and measured approximately 1 cm × 1 cm; the two masses appeared symmetrically on the superolateral aspects of the orbital rim. The cysts were soft, movable, and not tender, and there was no evidence of an influence on the other structures. For an exact evaluation of the masses, computed tomography (CT) with enhancement was performed. CT showed bilateral cystic masses on both zygomaticofrontal areas. The left cyst measured approximately 1.1 cm × 0.7 cm and the right one, 1.3 cm × 0.7 cm. There was no intraorbital or intracranial involvement (Fig. 2). Further, no deformity of bony structures under the masses was observed. We planned the excision of the masses under local anesthesia. Via incision on the inferior margin of the lateral ends of the patient’s eyebrows and meticulous subcutaneous dissection, we excised the masses completely without rupture (Fig. 3). There was dense adhesion between the periosteum and the cysts. The right cyst was slightly bigger than the left one, approximately 1.5 cm × 0.9 cm vs. 1.2 cm × 0.7 cm. After the excision of the masses, shallow imprints of the masses were visible on the underlying bone. The incisions were sutured with 5-0 polydioxanone and 6-0 nylon. Pathologic diagnosis confirmed that the two masses were dermoid cysts. There were no complications, and the incisions healed with acceptable scarring and a camouflage effect. The depressed contour deformities recovered after a few months. Dermoid cysts are benign tumors that can be found IMAGES