Dermoid Cyst of the Ethmoid Sinus

Introduction:

Dermoid cysts are rare congenital anomalies, containing ectoderm and mesoderm. Its pathogenesis involves the incomplete obliteration of neuroectoderm in the developing frontonasal region. The wall of the cyst consists of multilayered keratinous squamous epithelium and skin adnexa and contains tallow, shed epithelium and hair.

Case report:

A 30-year-old woman presented with a 6-year history of occasionally painful mass and pressure in the medial eye angle. Vision and ocular motility were not affected. Physical examination showed a not displaceable, firm, elastic tumor of the left medial eye corner. The CT and MRI revealed a 22 × 11 × 16 mm measuring mass from the left ethmoid sinus to the medial eye angle with fat typical density values. The bony walls of the medial orbita and the frontal skull base were not clearly visible. The patient underwent complete removal by an external approach. Intraoperatively, a frontal bone lesion or an intracranial extension could be excluded. The tumor itself contained serous secretion, tallow and solid elements with hairs which raised the suspicion of a dermoid cyst. Histological examination confirmed the diagnosis. The postoperative course was without any complication.

Conclusion:

Nasal dermoid cysts become usually conspicuous in the early infancy with a visible and palpable swelling because of their superficial location, but should also be taken into consideration in older patients. CT and MRI should be performed preoperatively in order to determine the extent of the dermoid cyst and to define the surgical approach.

Publication History

Publication Date:
18 April 2018 (online)