A 16-year-old female presents with a gradually enlarging, painless orbital swelling that has persisted for 10 years. What is the most likely diagnosis?
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Painless, slowly enlarging orbital swelling since childhood or adolescence = dermoid cyst.
Concept:
A dermoid cyst is a congenital benign cystic lesion commonly seen around the orbit. It is usually painless, slowly progressive, and may be present for many years.
Step 1: Identify the nature of swelling.
The swelling is:
\[
\text{Painless + gradually enlarging + long duration}
\]
This suggests a benign congenital lesion.
Step 2: Relate with orbital location.
Dermoid cysts commonly occur near the orbital margin and may present as a painless swelling since childhood.
Step 3: Rule out other options.
Capillary hemangioma usually presents in infancy. Lacrimal gland carcinoma is painful and progressive. Osteoma is a bony lesion and less likely here.
Therefore, the most likely diagnosis is Dermoid cyst.
