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Topic Completed: 1 February 2014

Minor changes: 5 October 2021

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PubMed Search: Cysts [title] eyelid

Nat Pernick, M.D.
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Cite this page: Pernick N. Cysts-eyelid. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyeeyelidcysts.html. Accessed December 3rd, 2021.
Definition / general
  • Common, represent 1/3 of eyelid lesions
  • Cysts listed below are benign
  • Excision is curative
Dermoid cyst
Definition / general
  • Usually upper eyelid along brow margin
  • May represent intraorbital mass that is pushed forward
  • Often attached to periosteum of bony orbital rim

Gross description
  • Soft, nontender, round / oval, 1 cm or less

Microscopic (histologic) description
  • Lined by well differentiated epidermis and dermis, lumen filled with keratinous debris, hair, sebum
  • May have foreign body inflammatory reaction if cyst ruptures

Differential diagnosis
Keratinous cyst (epidermal inclusion cyst)
  • Most common eyelid cyst
  • Either congenital, posttraumatic or postsurgical
  • Lined by squamous epithelium and contains laminated keratin
  • Marked foreign body giant cell reaction if cyst ruptures
  • No dermal appendages
Hidrocystoma (sudoriferous cyst)
  • Arise from eyelid sweat glands
  • Thin walled transparent vesicles at margin of lid, lined by atrophic cuboidal or flattened epithelial cells containing watery fluid or with an empty lumen ("sudoriferous" means carrying or producing sweat)
  • Lined by 1 - 2 layers of flattened cuboidal cells
Apocrine hidrocystoma
  • Lined by double layer of columnar cells with eosinophilic cytoplasm, papillary projections and apocrine snouts
  • Develop from obstructed ducts of glands of Moll, are often multiple at eyelid margin
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