Epidermoid Cyst vs. Neuroblastoma

Left picture: In this case the diagnosis is a frontotemporal epidermoid cyst of the lateral eyebrow, which is a typical and frequent location of epidermoid cysts. Right picture: The diagnosis is a metastasis of a neuroblastoma grade IV of the right adrenal gland in the region of the right orbita and of the frontotemporal skull, with expansion into the soft tissues. Both diagnoses can be suspected with high reliability. In the case of the suspected neuroblastoma metastasis, multiple additional examinations are necessary, which are not necessary in most cases of epidermoid cysts at this location.

Both children have a lateral periorbital swelling. Left picture: The swelling lies on the left side of the face. Right picture: In this case the swelling is on the right side of the face. Left picture: The mass is localized at the lateral end of the brow. Right picture: In this case the mass is not well demarcated, continues to the temple, is recognizable by the soft tissue contours in comparison with the contralateral side, and is soft on palpation. Both patients are infants, but the natural history is different. Right picture: The mass developed within one month. Left picture: In this case the mass has been known since a couple of months and is slowly growing.