Dermoid Cyst: Developing from dermal elements, these cysts occur when tissue gets pinched of along suture lines in the course of development. In children, these lesions are usually located in the lateral brow and are smooth, palpable, and mobile. Often they have a firm, rubbery consistency. In adults, the dermoid cysts are often not palpable, usually superior and temporal in position, and deeper within the orbit. They are also not mobile as in children. These lesions can displace the globe and adnexa, cause erosion of bone, and can attach to dura through defects in the roof. CT scanning often shows bony erosion or extension intracranially in a dumbbell shaped fashion. Occasionally after seemingly mild trauma, these cyst can rupture and cause a foreign body inflammatory reaction. Careful dissection to remove the entire dermoid cyst without rupture of the capsule is required in children to prevent an inflammatory reaction to the to the cyst contents. In adults, if the lesion extends intracranially and the lesion needs to be removed a neurosurgical approach may be required. Histopathologically, the cyst consists of a lining of keratinized epithelium with dermal appendages in wall, hair follicles and sebaceous glands. Back to Orbit