Conjunctival Epithelial Inclusion Cyst following Evisceration with Primary Orbital Implantation

A 29-years-old Turkish man who had undergone evisceration with primary orbital implantation 20 months prior complained of difficulty wearing his artificial eye. Slit-lamp examination revealed a conjunctival cyst in the center of the anophthalmic socket, with no evidence of scleral or orbital implant exposure. The cyst was completely excised under general anesthesia and did not require use of any sclerosing substance or dye. At 6 months postoperatively, there was no recurrence of the cyst or exposure of the sclera or orbital implant. As the upper and lower fornices were sufficiently deep, the patient could wear his artificial eye.

Epithelial inclusion cyst of the equine digital flexor tendon sheath: diagnosis by ultrasonography and magnetic resonance and successful treatment by tenoscopy

A six-year-old warmblood horse was presented with a longstanding frontlimb lameness with mild digital flexor tenosynovitis and swelling of the distomedial pastern. Ultrasonography and magnetic resonance revealed a dense mass lesion in the distal aspect of the digital flexor tendon sheath, with a partial lamellar architecture, absence of internal vascularization and adjacent smooth pressure osteolysis of the middle phalanx. After surgical excision, histopathology confirmed an epithelial inclusion cyst. Epithelial inclusion cysts, also known as keratinizing or follicular cysts, are expansile benign mass-like lesions of aberrant epidermal tissue. In the horse, they are known to occur in cutaneous and several non-cutaneous tissues. In the digital flexor tendon sheath, they have rarely been described. Given their often chronic presentation in this location, they may appear as an atypical dense mass on imaging, uncommon for cystic lesions. Complete tenoscopic removal, even for larger masses, is achievable and considered curative with good prognosis for return.

A typical manifestation of conjunctival epithelial inclusion cyst

Purpose: To report a case of conjunctival epithelial inclusion cyst with atypical manifestation.Methods: A 26-year-old male presented with a blackish-brown, subconjunctival mass located in palpebral conjunctiva of the upper eyelid. En bloc excision of the mass was performed and evaluated on histopathological examination.Results: The excised mass was well defined, dark brown in colour and simulated a solid foreign body. On histopathological examination, the mass was lined by stratified squamous epithelium with florid hyperkeratosis and haemorrhage inside it, consistent with atypical conjunctival epithelial inclusion cyst.Conclusion: A careful clinical examination and histopathological study is essential for the differential diagnosis of subconjunctival mass as rarely they may present with atypical manifestations.