Intratarsal Keratinous Cyst – An Emerging Entity
A 76-year-old male with a history of a car accident in December 2008, with the subsequent repair of a ZMC fracture, a left paralytic ectropion repair using ear cartilage in March 2009, a left upper eyelid wedge resection for floppy eyelid syndrome in December 2009, left ptosis repair, blepharoplasty and the removal of a glass foreign body from the medial canthus in February 2010 presented with a complaint of left eye pain that had not changed since the car accident. Examination revealed a visual acuity of 20/25 +1 on the right, and pinhole visual acuity of 20/20 on the left. Additionally, he had Meibomian gland dysfunction and a tarsal cyst on the left upper eyelid at the site of the previous wedge resection. A wedge resection of the tarsal cyst was performed. Histologic analysis revealed a keratinous cyst in the tarsus, lined by stratified squamous epithelium featuring crenulations; the superficial layers of the epithelium were eosinophilic. There was keratinous material within the cyst as well as scarring and a chalazion surrounding the cyst (fig. ). There was not sufficient tissue to perform immunohistochemical analysis.