J Rhinol.  2022 Mar;29(1):48-51. 10.18787/jr.2021.00373.

Removal of Traumatic Hematic Cyst of the Orbit Through Sub-Brow Approach

• Kim D
• Gwak JW
• Ryu SS
• Yu MS

• KMID: 2528320
• DOI: http://doi.org/10.18787/jr.2021.00373

Abstract

Orbital hematic cyst is characterized by cystic accumulation of hematogenous debris surrounded by a wall of fibrous tissue without an epithelial lining. It is a relatively uncommon benign cyst and occurs secondary to blunt trauma in most cases. We experienced a case of 53-year-old male who presented with proptosis of the left eye. A cystic lesion was found at the superolateral orbital rim of the patient. We report a case of orbital hematic cyst that was resected completely through the sub-brow approach.

Keyword

Hematic cyst; Incision below eyebrow; Orbit

Figure

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  Fig. 1. Preoperative facial photos. A: Frontal view of preoperative facial photo. B: Lateral view of preoperative facial photo.

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  Fig. 2. Preoperative radiological imaging. A: Coronal view of contrast computed tomography (CT) scan represents about 2 cm-sized cyst was pressing down the superior rectus muscle inferomedially. B: Axial view of contrast CT shows that non-enhancing cyst was extending to intraconal space of the orbit. C: In T2-weighted magnetic resonance imaging (MRI) scan, a cyst which originated from superolateral orbital rim showed internal high signal density. D: In contrast-enhanced T1-weighted MRI scan, well enhancing lesion was identified.

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  Fig. 3. Intraoperative findings. A: Sub-brow incision line was drawn (arrow). B: Upper portion of the orbital rim was exposed by sub-brow incision. C: Yellowish non-epithelial contents of the orbital hematic cyst was identified (arrow).

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  Fig. 4. Pathologic findings. A: Cholesterol clefts (arrow) due to lipid-laden macrophages. Yellow-brownish crystalloid materials suggesting old hemorrhage (Original magnification ×100, hematoxylin and eosin). B: Collections of red blood cells without vascular lining surrounded by formation of fibrous tissues (Original magnification ×300, hematoxylin and eosin).

Reference

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