ABSTRACT
The epidermal cyst is a benign cyst that develops out of the ectodermal tissue. The epidermal cyst may have no symptoms. The definitive diagnosis is made after an excisional biopsy based on microscopic appearance. A 49-year-old woman presented with a painless left lower eyelid mass. Examination revealed a firm, globular mass that was fixed to the tarsal plate of the lower eyelid. An excisional biopsy was performed that revealed an epidermal cyst. As with epidermal cysts in other locations, surgical excision is the treatment of choice. The Tenzel semicircular flap procedure is selected for eyelid reconstruction in this case. Histopathologic sections demonstrated a cyst line by a squamous epithelium containing keratin, consistent with the diagnosis of an epidermal cyst. The moderately sized epidermal cyst of the lower eyelid was successfully managed by surgical excision using the Tenzel semicircular flap procedure, which gives the best outcome for palpebral epidermal cysts, especially those of moderate size.
