Korean J Ophthalmol.  2007 Jun;21(2):120-123. 10.3341/kjo.2007.21.2.120.

Congenital Sudoriferous Cyst within the Orbit Followed by Esotropia

• Chung JK
• Lee SJ
• Kang SK
• Park SH

• KMID: 1101915
• DOI: http://doi.org/10.3341/kjo.2007.21.2.120

Abstract

PURPOSE: To report a case of congenital sudoriferous cyst of the orbit with esotropia. METHODS: A 20-day-old male, born prematurely presented with a palpable lump on left upper lid. Orbital ultrasonography including color doppler image and orbital magnetic resonance image were performed to evaluate the lid lesion. The mass was excised and histologically examined. Complete ocular examination including visual acuity, duction, version, and the presence of strabismus were performed. RESULTS: A well circumscribed round cystic mass, measuring 1.4 x 1.3 cm was noted at medial superior aspect of the left orbit. It compressed and displaced the left globe to inferior posterior position with intact optic nerve. Histopathologic examination showed the lesion to be a solitary sudoriferous cyst lined by two layers of cuboidal epithelial cells with eosinophilic cytoplasm. After the excision of the mass, limitations of extraocular muscle movements, esotropia, and amblyopia were noted. CONCLUSIONS: If an orbital cyst affects the globe or extraocular muscles, it should be excised as soon as possible to prevent strabismus and amblyopia especially in infant.

Keyword

Amblyopia; Esotropia; Sudoriferous cyst

MeSH Terms

Cysts/complications/*congenital/diagnosis
Diagnosis, Differential
Esotropia/diagnosis/*etiology
Follow-Up Studies
Humans
Infant, Newborn
Magnetic Resonance Imaging
Male
Orbital Diseases/complications/*congenital/diagnosis
*Sweat Glands
Ultrasonography, Doppler, Color

Figure

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  Fig. 1 (A) A round palpable pinkish lump on left upper lid with limitation of eye opening due to the mass. (B) Three dimensional reconstruction of orbit MRI. (C) An orbit ultrasonography shows well circumscribed, round, anechogenic cyst (left) and the left globe is displaced to posterior lateral portion and compressed by the mass (right). (D) Orbit MRI. A 1.4×1.3 cm sized circumscribed, round, cystic mass in medial superior aspect in left orbit. Eye ball is displaced to the inferior posterior portion with intact optic nerve and the mass shows low signal intensity on Gd-DTPA enhancement sagittal T1WI.

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  Fig. 2 (A) Intraoperative finding of cyst excision shows a gray white cystic mass is attached to upper palpebral conjunctiva with two fibrous pedicles. (B) A cross section of the cyst filled with cystic fluid shows an unilocular cystic mass which consists of a thin fibrous wall (×14). Hematoxylin and Eosin stain. (C) The luminal surface is lined by two layers of atrophic, non-keratinizing cuboidal or flattened cells; the innermost cells show apical expansions, granular, deeply eosinophilic cytoplasm and basally located round nucleus (×400).

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  Fig. 3 (A) There is no focal abnormal echogenicity in the left eye, which is rotated medially without movement during examination. (B) Post-operative photograph showing esodeviation. 30 PD esotropia was determined by the Krimsky method and an abduction limitation was found in both eyes. (C) Computed tomography scan reveal no eyeball deformity and normal extraocular muscles.

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