Giant cyst of buttock secondary orbital dermis-fat graft in a child with MRSA – case report
Author: Biljana Kuzmanović Elabjer
Base Hospital / Institution: University Eye Department, University Hospital „Sveti Duh”, Zagreb, Medical Faculty Osijek, Faculty of dental medicine and health Osijek, J.J. Strossmayer University of Osijek
ePoster presentation
Abstract ID: 25-117
Purpose
To report a rare case of a giant cyst following a secondary dermis-fat orbital graft in a 5-year-old boy with a history of multiple relapses of retinoblastoma, orbital methicillin-resistant Staphylococcus aureus (MRSA) colonization, and subsequent anophthalmic socket syndrome.
Methods
A 5-year-old boy presented with right-sided proptosis one year after receiving a secondary dermis-fat orbital graft. He had undergone 12 cycles of intravitreal, intra-arterial, and systemic chemotherapy, as well as thermotherapy and cryotherapy due to recurrent retinoblastoma in the right eye. Following a third relapse, secondary enucleation was performed with a primary silicone orbital implant. However, extrusion of the implant occurred six days postoperatively, and an orbital swab confirmed MRSA colonization. After prolonged systemic and local treatment, a secondary dermis-fat graft was harvested from the right buttock and implanted after ensuring MRSA clearance. The graft healed well, and an eye prosthesis was fitted. A year later, the child developed rapid right-sided proptosis with eyelid enlargement. Ultrasound revealed a cyst within the dermis-fat graft that measured 23.6 mm in the anteroposterior diameter. Surgery was postponed due to chickenpox, and the cyst enlarged, reaching an anteroposterior diameter of 26.7 mm over two months.
Results
The cyst was completely excised, and the surgery was uneventful.
Conclusion
Giant cyst formation in a dermis-fat graft is an extremely rare complication. Complete excision remains the treatment of choice. However, in this case, it resulted in persistent anophthalmic socket syndrome, posing further reconstructive challenges.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Mirjana | Bjeloš | University Eye Department, University Hospital „Sveti Duh”, Zagreb, Medical Faculty Osijek, Faculty of dental medicine and health Osijek, J.J. Strossmayer University of Osijek |
| Ana | Ćurić | University Eye Department, University Hospital „Sveti Duh”, Zagreb, Medical Faculty Osijek, Faculty of dental medicine and health Osijek, J.J. Strossmayer University of Osijek |
| Mladen | Bušić | University Eye Department, University Hospital „Sveti Duh”, Zagreb, Medical Faculty Osijek, Faculty of dental medicine and health Osijek, J.J. Strossmayer University of Osijek |
| Daliborka | Miletić | University Eye Department, University Hospital „Sveti Duh”, Zagreb, Medical Faculty Osijek, Faculty of dental medicine and health Osijek, J.J. Strossmayer University of Osijek |
