Dermolipome: aspect per-opératoire

Dermolipoma is an ectopic skin formation with a greasy component which develops at the level of the fornix of the external canthus. Surgery for dermolipoma is not devoid of dangers. There is essentially a risk of causing damage to the right external muscle and levator muscle of the upper eyelid because there is no cleavage plane between the lesion and the adjacent normal tissues to which it adheres. The anterior surface of the dermolipoma is inseparable from the temporal bulbar conjunctiva. Its posterior surface is adjacent to the right lateralis muscle and can extend up to the levator Müller's muscle complex of the upper eyelid and toward the lachrymal gland. We report the case of a 56-year old patient presenting with a yellowish white lesion of the external canthus of the right eye. The patient underwent orbital scanner in order to exclude the possibility of orbital extension and to establish the relationship with the different ocular structures. Given the aesthetic discomfort, the patient underwent surgical resection of the orbital grease in front of the orbital rim. The main differential diagnoses included conjunctival cyst, complex choristoma and dermoid cyst. Anatomopathological examination confirmed the diagnosis of dermolipoma. The postoperative course was uneventful.