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This is a 5-month-old girl whose mother notices a swelling on the lateral side of the left eye at one month of age. The mother is concerned about the mass enlarging, but so far she states that it is remaining the same size. She also states that the eye has appeared red a few times. The child appears to see normally, refraction is +0.50 in each eye and the remainder of the examination is normal and there is no proptosis. The mass has a yellowish appearance.

1.	What is the most likely diagnosis?
	d -- dermolipoma This is the typical appearance of a lipodermoid.
2.	The diagnosis in this case is aided by:
	d -- (a), (b), and (c). The location, color, and lack of increase in size contribute to the diagnosis.
3.	The best management is:
	a -- simply observing In a case like this the patient should be simply observed.
	Dermolipoma is classified as a choristoma.  It has little potential for growth. It is made up of displaced rests of epithelial and dermal tissue. Dermolipomas are a variant of dermoid cysts and are found typically at the temporal aspect of the globe as seen in this patient. These lesions differ from the typical dermoid cyst in that they have adipose tissue in them. It is best to simply observe this patient and watch for growth. It probably will not grow. Surgery should be AVOIDED unless absolutely necessary. If surgery is done it should be done very carefully while avoiding going into the orbit. Going into the orbit in an attempt to remove a dermolipoma can result in restrictive strabismus.