What Does A Hard Lump Between Left Eye And Temple Indicate?

Posted on Sun, 9 Mar 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 9 Mar 2014 Answered on

Tue, 1 Apr 2014 Last reviewed on

Question : I am a 15 year old boy. Yesterday i found a small, immovable, hard, and stationary lump that appears to be attached to bone between my left eye socket and my left temple. The lump itself has bone-like qualities (hard, stationary, etc.) Based on what i have read, it appears that this is likely some type of cyst. Can something like this cause health risks, or should it only be dealt with if it becomes a cosmetic concern? Thanks

Answered by Dr. Dadapeer K (48 minutes later)

Brief Answer: From the history it appears like dermoid cyst. Detailed Answer: Hello Welcome to health care magic I am Dr Dadapeet, an ophthalmologist and I answer health problems related to eye. It seems from the history that you are having a lump between left eye and temple and the lump is hard to firm in consistency. From the history you have given it appears like dermoid cyst. This usually appears at the junction of the bony eye socket with the surrounding bones. The treatment is indicated if the lump causes cosmetic disfigurement or interferes with the vision. Usually dermoid cysts are benign or non harmful lesions and they will not lead to any complications. If possible do send a photo of the affected eye so that I can answer your question more accurately. Hope the information is helpful to you. Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dadapeer K (32 minutes later)

The bump is not visible from the outside; it is under the skin and appears to be attached to the bone. Again: The bump is small, hard, immovable and stationary. It is located under the skin, right where I am pointing my finger. Should I have this cyst removed?Thanks. Would you advise getting the cyst removed, just to be on the safe side? If so, how long does this procedure take?

Answered by Dr. Dadapeer K (1 hour later)

Brief Answer: It appears like orbital dermoid cyst. Detailed Answer: Hello Thank you for the follow up. I reviewed the photo attached with the query. The upper and outer part of the eye socket or orbit is the most common site of occurrence of dermoid cyst. It occurs at the site of fusion of the bones along the suture lines. Since it is barely visible it can be orbital dermoid cyst which will be attached to the orbital bone. Sometimes it will have deeper extensions and these can be made out by radiological tests like CT scan. Normally dermoid cysts can be left alone with regular follow up and requires removal on cosmetic disfigurement. Rarely they can rupture and cause symptoms of inflammation like pain and very very rarely malignant transformation can be seen hence they are followed up at regular intervals and removed if any of these probems occur. So to conclude the lesion is appearing like dermoid cyst involving the bones of the orbit. Since the cyst is very small without causing any cosmetic problem this can be left alone and observed. However I advice you to undergo examination once for confirmation of diagnosis and investigations like CT scan to look for deeper intraorbitl or intracranial extensions. Hope I have answered your question and the information is helpful to you. Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dadapeer K (1 minute later)

Thanks. Would you advise that I get the cyst removed, just to be on the safe side? And if so, is this a simple/quick procedure?

Answered by Dr. Dadapeer K (4 hours later)

Brief Answer: If is Superficial I advice it to be removed. Detailed Answer: Hello Thank you for the follow up If you see slow increase in the growth of the lump or if it is superficial without deep extensions I advice to get it removed by surgery. In case if you want to get it removed by surgery you need to get investigation like CT scan to find out the deeper extensions of the lesion. The cyst has to be removed in total and without rupture of contents as this can cause recurrence of the cyst. If the cyst is not having any deeper extensions then surgery is a simple and quick procedure which can be done as a day care surgery under local anesthesia. The cysts with deeper extensions need to be removed carefully after analyzing the advantages and disadvantages and may require a more complex surgery. Hence I advice you to first consult your ophthalmologist for confirmation of diagnosis and to know the type of dermoid cyst to decide on whether it has to be removed or to be left alone. Hope I have answered your questions and the information is helpful to you. Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dadapeer K (34 hours later)

Ok. About an hour ago I went to the dermatologist. I usually go to the dermatologist for my acne. I wouldnt consider my acne severe, but my face does break out occasionally. So, today, the dermatologist injected all of the pimples on my face with what I believe was cortisone. I also told her about the lump that I told you about. Without feeling it or examining it, she said that it was a cyst and that the injections will get rid of the cyst "quickly". It has been about an hour, and the lump has not reduced in size, nor have the pimples subsided. Is this normal, and if so, how long will it take for the lump to disappear?

Answered by Dr. Dadapeer K (3 hours later)

Brief Answer: Treatment of dermoid cyst is by surgical removal. Detailed Answer: Hello Thank you for the follow up The best method of treatment of dermoid cyst is surgical removal and it is not known to respond to injection of steroids,only the inflammatory lesions like pimples, chalazion.... are known to respond to pimples. This action may take about one week for its action. So if the lump were to be a dermoid cyst it will not disappear, however if is something else of inflammatory origin then it may disappear. Hence I advice you to get the examination done by a surgeon or by a ophthalmologist for confirmation of diagnosis and treatment accordingly if the lump won't disappear. Hope I have answered questions and the information is helpful to you. THANK YOU

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dadapeer K (48 minutes later)

When should I get the cyst removed? When it grows to a size that is a cosmetic problem?

Answered by Dr. Dadapeer K (39 minutes later)

Brief Answer: Increase in size is definite indication for remova Detailed Answer: Hello Thank you for the follow up Since you have undergone injection of steroid you can wait for 1-2 weeks, if there is no reduction in size it confirms our diagnosis of a cyst like dermoid cyst. If there is increase in size or there symptoms like pain you need to get it removed by surgical excision. If there is no increase in size it can be followed up with frequent examinations after confirmation of diagnosis either by examination by a ophthalmologist or by radiological tests like CT scan. Hope I have answered your questions and the information is helpful to you. Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar