A Case of Post-traumatic Necrobiotic Xanthogranuloma of the Orbit

Hyun Joon Choi; Hee Jung Kwon; Hye Young Kim

doi:10.3341/jkos.2008.49.4.677

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Choi, Kwon, and Kim: A Case of Post-traumatic Necrobiotic Xanthogranuloma of the Orbit

Original Article

J Korean Ophthalmol Soc 2008;49(4):677-680.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.4.677

A Case of Post-traumatic Necrobiotic Xanthogranuloma of the Orbit

Hyun Joon Choi, M.D., Hee Jung Kwon, M.D., Hye Young Kim, M.D.

National Health Insurance Corporation Ilsan Hospital, Gyeonggi, Korea

Address reprint requests to Hye Young Kim, M.D. National Health Insurance Corporation Ilsan Hospital #1232 Backsuk1-dong, Ilsandong-gu, Goyang-si, Gyeonggj 410-719, Korea Tel: 82-31-900-0590, Fax: 82-31-900-0049, E-mail: khyeye@hanmail.net

Received 7 May 2007 Accepted 10 October 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the role of nitric oxide (NO) on the migration of cultured human Tenon's capsule

Purpose

Necrobiotic xanthogranuloma is a very rare disease characterized by the presence of yellow subcutaneous skin lesions and systemic paraproteinemia. We report a case of post‐ traumatic necrobiotic xanthograuloma that presented with a preseptal mass.

Case summary

A 31-year-old man presented with ptosis and a mass on the left superior orbit that developed after trauma 3 weeks prior to admission. A computed tomography scan showed a contrast-enhancing preseptal mass, and surgical exploration was performed.

Conclusions

Histopathological examination revealed a tumor that had all the major features of necrobiotic xanthogranuloma, including fat necrosis with granulomatous inflammation, giant multinucleated cells, foamy cells, and several lymphoid follicles with germinal centers. Hematologic evaluation revealed polyclonal gammopathy.

Keywords: Necrobiotic xanthogranuloma, Orbital tumor, Paraproteinemia, Polyclonal gammopathy

References

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Figure 1.

Clinical photograph of a 31-year-old man with 3-week history of ptosis of the left eye.

Figure 2.

Orbital computed tomography scans showed ill-defined, contrast‐ enhancing mass in the preseptal space (arrows). (A) contrasted, (B) non-contrasted. (preinjection)

Figure 3.

The granulomatous infiltrate consisted of histiocytes mixed with lymphocytes, foamy cells, multinucleated giant cells, and Touton cells (arrows). (HE stain, original magnifications ×100)

Figure 4.

One-month postoperative photograph showed no mass lesion or ptosis.

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