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Multicenter Study
. 2016 Jan;30(1):59-63.
doi: 10.1038/eye.2015.184. Epub 2015 Oct 2.

Clinical features of intratarsal keratinous cysts

J A Kim  1 , N Kim  2 , H-K Choung  3 , M J Lee  4 , C Lee  5 , S I Khwarg  1
Affiliations
Multicenter Study

Clinical features of intratarsal keratinous cysts

J A Kim et al. Eye (Lond). 2016 Jan.

Abstract

Purpose: Intratarsal keratinous cysts (IKCs) have been frequently misdiagnosed as chalazia or epidermal cysts. We reviewed a series of cases of IKCs to identify clinical features that distinguish IKCs from other eyelid diseases.

Methods: We retrospectively reviewed the medical records of 17 suspected IKC patients between January 2004 and September 2014.

Results: Seventeen patients who were clinically suspected to have IKC were enrolled. All patients presented with non-inflamed eyelid nodules fixed to the tarsus. Among them, 12 biopsy specimens were available and 11 patients (91.7%) were diagnosed with IKC, with a pathological finding of stratified squamous cell lining with keratin material. The mean patient age was 55.1 years (31-71). Six patients had a surgical history of incision or incomplete excision of the lesion, followed by recurrence. On eyelid eversion, five patients showed a white-yellow nodule, and three patients had a bluish cystic lesion. The diameter of the nodules ranged from 4 to 10 mm. The intracystic material was a milky white fluid. Ten patients underwent a complete surgical excision including partial tarsectomy and there was no recurrence.

Conclusions: IKC can be distinguished from other intratarsal lesions by a characteristic tarsal nodule fixed to the tarsus. To prevent recurrence, complete excision with partial tarsectomy is needed.

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Figures

Figure 1
Figure 1
Photographs of intratarsal keratinous cysts. (a) Whitish, 6-mm, elevated nodule without signs of inflammation. (b) Blue, 8-mm, palpable intratarsal nodule.
Figure 2
Figure 2
Histological findings of an intratarsal keratinous cyst. (a) Benign keratinous cyst adjacent to the Meibomian gland (Hematoxylin–eosin stain, original magnification: × 40). (b) The cyst lined by undulating squamous epithelium without the granular layer (Hematoxylin–eosin stain, original magnification × 200).
See this image and copyright information in PMC

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