Giant Primary Conjunctival Inclusion Cyst: A Case Report and Brief Literature Review

A conjunctival cyst is a slow-growing benign lesion that forms beneath or on the conjunctiva. Inclusion cysts contribute to most cases, more commonly secondary than primary. In an inflamed inclusion cyst, inflammatory features may or may not be seen clinically but can be confirmed on histopathological evaluation after surgical excision of the cyst. Removal of the cyst surgically with complete cyst wall excision is desirable in all conjunctival cysts. We report a giant conjunctival inclusion cyst in a 44-year-old female with no history of trauma or surgery. The patient had a history of a tiny cyst present since childhood and was found to enlarge gradually to the present size in the last 4 months. The cyst was excised entirely without rupturing the wall. Histopathology of the excised tissue showed a thin-walled cystic structure lined by nonkeratinized epithelium stratified at places. The wall was composed of fibrocollagenous tissue infiltrated by sparse inflammatory cells with a predominance of lymphocytes forming lymphoid nodules. The histological diagnosis was consistent with a conjunctival inclusion cyst. Primary inclusion cysts are mostly present since childhood and often remain asymptomatic. The size may later increase and become symptomatic when triggered by some factors like trauma, infection, inflammation, and drugs.