# Therapeutic challenges in epidermal inclusion cysts with periocular localization: case reports

## TL;DR

This paper presents two rare cases of epidermal inclusion cysts near the eye, highlighting their unique locations and successful surgical removal.

## Contribution

The paper reports rare cases of epidermal inclusion cysts attached to the tarsus with no prior trauma or inflammation.

## Key findings

- Two cases of epidermal inclusion cysts in the periocular region were successfully surgically removed.
- Histological analysis confirmed the presence of keratinized squamous layers, typical of epidermoid cysts.
- The cases highlight the challenges in managing large cysts in delicate periocular locations.

## Abstract

Epidermal inclusion cysts in the periocular region are distinctive pathologies exhibiting varied clinical and radiological features, and they should be taken into consideration in the differential diagnosis of cystic lesions near the orbit. This article discusses the clinical and radiological details, along with the surgical results, of two individual cases of epidermal inclusion cysts, with different localization and without any preceding trauma, surgical history, or eyelid inflammation. In the first case, a substantial spherical structure closely connected to the tarsal plate was identified via excisional biopsy, whereas the second case involved a soft, oval tumor located at the outer right orbital corner, as determined clinically and validated through computed tomography. The histological examination showed cysts lined with a keratinized squamous layer, confirming an epidermoid cyst. The surgical removal of the cysts led to esthetically satisfactory outcomes in both cases. The particularity of the presented cases lies in the locations and considerable sizes of the tumors, which have complicated their surgical management. Such instances of epidermal inclusion cysts attached to the tarsus are rarely reported in the literature.