Organized Fibrous and Calcified Thrombus of the Medial Canthus Mimicking a Dermoid Cyst: A Clinicoradiological and Histopathological Correlation
- 1Department of Ophthalmology, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR
Abstract
Medial canthal masses encompass a broad range of lacrimal, congenital, inflammatory, vascular, and neoplastic lesions. Their clinical and radiological features may overlap, making an accurate preoperative diagnosis challenging. We report the case of a 31-year-old woman presenting with a painless, slowly enlarging right medial canthal mass with a four-year history. Examination revealed a firm, non-tender, and non-compressible lesion without inflammatory signs, epiphora, proptosis, diplopia, or ocular motility restriction. Lacrimal irrigation confirmed a patent drainage system. Ultrasonography demonstrated an 11 × 10 mm lesion containing a central hyperechoic focus with posterior acoustic shadowing, consistent with calcification. Computed tomography dacryocystography showed a well-circumscribed medial canthal mass with central calcification and a patent ipsilateral lacrimal drainage system. A dermoid cyst was suspected preoperatively. Complete excision was performed through an external medial canthal approach. Histopathological examination demonstrated a large-caliber vascular structure with a lumen largely obliterated by an organized thrombus composed of fibrin and entrapped red blood cells, with dense fibrosis, cholesterol clefts, and dystrophic calcification. These findings established the diagnosis of an organized fibrous and calcified thrombus. The postoperative course was uneventful, with satisfactory healing and no clinically evident recurrence at the two-month follow-up. This case illustrates how advanced organization, fibrosis, and calcification can obscure the vascular nature of a lesion and closely mimic a dermoid cyst. In this case, histopathological examination was decisive in establishing the definitive diagnosis.
Related
- Organized and Calcified Testicular Hematoma Mimicking a Neoplasm: A Case Report
- Giant Pelvic Cyst Mimicking a Para-Ovarian Cyst: A Diagnostic Challenge With Successful Surgical Excision and Histopathological Correlation.
- Gastritis Cystica Profunda With High-Grade Dysplasia Mimicking Gastrointestinal Stromal Tumor: A Histopathological Pitfall in the Assessment of Submucosal Invasion.
- CT radiomics-histopathological correlation for mediastinal lymph node staging in non-small cell lung cancer
- Greater occipital neurectomy for refractory occipital neuralgia secondary to neurovascular compression: Anatomical Correlation, histopathological findings, and systematic review.
BibTeX
@article{safwate2026organized,
title = {{Organized Fibrous and Calcified Thrombus of the Medial Canthus Mimicking a Dermoid Cyst: A Clinicoradiological and Histopathological Correlation}},
author = {Houda Safwate and Hala Ait Amar and Yacout Hazzaz and Mehdi Khamaily and Mohamed Elbelhadji},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117293},
url = {https://europepmc.org/article/PMC/PMC13723156},
note = {CC BY},
}
RIS
TY - JOUR
TI - Organized Fibrous and Calcified Thrombus of the Medial Canthus Mimicking a Dermoid Cyst: A Clinicoradiological and Histopathological Correlation
AU - Houda Safwate
AU - Hala Ait Amar
AU - Yacout Hazzaz
AU - Mehdi Khamaily
AU - Mohamed Elbelhadji
PY - 2026
DA - 2026/10/01
JO - Cureus
DO - 10.7759/cureus.117293
UR - https://europepmc.org/article/PMC/PMC13723156
AB - Medial canthal masses encompass a broad range of lacrimal, congenital, inflammatory, vascular, and neoplastic lesions. Their clinical and radiological features may overlap, making an accurate preoperative diagnosis challenging. We report the case of a 31-year-old woman presenting with a painless, slowly enlarging right medial canthal mass with a four-year history. Examination revealed a firm, non-tender, and non-compressible lesion without inflammatory signs, epiphora, proptosis, diplopia, or ocular motility restriction. Lacrimal irrigation confirmed a patent drainage system. Ultrasonography demonstrated an 11 × 10 mm lesion containing a central hyperechoic focus with posterior acoustic shadowing, consistent with calcification. Computed tomography dacryocystography showed a well-circumscribed medial canthal mass with central calcification and a patent ipsilateral lacrimal drainage system. A dermoid cyst was suspected preoperatively. Complete excision was performed through an external medial canthal approach. Histopathological examination demonstrated a large-caliber vascular structure with a lumen largely obliterated by an organized thrombus composed of fibrin and entrapped red blood cells, with dense fibrosis, cholesterol clefts, and dystrophic calcification. These findings established the diagnosis of an organized fibrous and calcified thrombus. The postoperative course was uneventful, with satisfactory healing and no clinically evident recurrence at the two-month follow-up. This case illustrates how advanced organization, fibrosis, and calcification can obscure the vascular nature of a lesion and closely mimic a dermoid cyst. In this case, histopathological examination was decisive in establishing the definitive diagnosis.
SN - 2168-8184
ER -