Journal List > J Korean Ophthalmol Soc > v.49(12) > 1008168

Doh, Lee, and Yang: A Case of Primary Lipogranuloma in Eyelid

Abstract

Purpose

We report one case of primary giant lipogranuloma in the whole upper lid.

Case summary

A 37-year-old man with a left whole upper lid mass that developed 3 months prior to admission visited our hospital. Biopsy was performed, and lipogranuloma was diagnosed. We attempted to remove the lesion by non-surgical local triamcinolone injection with no effect, so we finally removed the lipogranuloma by surgical resection. In the postoperative histological findings, the upper lid mass showed variously sized multiple cystic spaces surrounded by macrophage infiltration and fibrosis consistent with lipogranuloma.

Conclusions

We report the first case of primary giant lipogranuloma in the upper eyelid in Korea. We considered repeated intralesional triamcinolone injections to be a better treatment method than surgical resection. Final surgical resection might be more effective, however, after an intralesional steroid injection to reduce the size of the lipogranuloma.

References

1. Rodríguez-Mzartín M, Sáez-Rodríguez M, Carrasco JL. . Self induced paraffinoma in a schizophrenic patient. J Am Acad Dermatol. 2007; 56:127–8.
2. Son MG, Kim YD. Lipogranuloma of Eyelids after Paranasal sinus surgery, J Korean Ophthalmol Soc. 1999; 40:2935–41.
3. Heltzer JM, Ellis DS, Stewart WB, Spencer WH. Diffuse nodular eyelid lipogranuloma following sutureless transconjunctival blepharoplasty dressed with topical ointment. Ophthal Plast Reconstr Surg. 1999; 15:438–41.
crossref
4. Ozdal PC, Codere F, Callejo S. . Accurracy of the clinical diagnosis of chalazion. Eye. 2004; 18:135–8.
5. Steven G. Silverberg, Silverberg’s Principles and practice of Surgical Pathology and Cytopathology. 4th. Vol. 1. Churchill Livingstone: Elsevier;2006. p. 141.
6. Duke-Elder S. System of ophthalmology, 1st ed. Vol. 13. St. Louis: C.V. Mosby,. 1974; 242–7.
7. Lucas DR. Greer’s ocular pathology. 4th. Oxford: Blackwell;1989. p. 81–98.
8. Yeatts RP, Waller RR. Sebaceous carcinoma of the eyelid: pitfalls in diagnosis. Ophthal Plast Reconstr Surg. 1985; 1:35–42.
9. Koo L, Hatton MP, Rubin PA. "Pseudo-pseudochalazion": giant chalazion mimicking eyelid neoplasm. Ophthal Plast Reconstr Surg. 2005; 21:391–2.
crossref
10. Kersten RC, Ewing-Chow D, Kulwin DR, Gallon M. Accuracy of clinical diagnosis of cutaneous eyelid lesions. Ophthalmology. 1997; 104:479–84.
crossref
11. Broekaert D, Goeman L, Ramaekers FC. . An investigation of cytokeratin expression in skin epithelial cysts and some uncommon types of cystic tumours using chain-specific antibodies. Arch Dermatol Res. 1990; 282:383–91.
crossref
12. Baek SH. Lipogranuloma in the upper lids. J Korean Ophthalmol Soc. 2000; 41:517–20.
13. Fenton S, Canninga-van Dijk MR, Mourists MP. Lipogranuloma of the nasolacrimal system, an iatrogenic and preventable entity. Eye. 2003; 17:528–30.
crossref
14. Goldwyn RM. The paraffin story. Plast Reconstr Surg. 1980; 65:517–24.
crossref
15. Hintschich CR, Beyer-Machule CK, Stefani FH. Pafaffinoma of the periorbit-a challenge for the oculoplastic surgeon. Ophthal Plast Reconstr Surg. 1995; 11:39–43.
16. Lang S, Dreher A, Grevers G. Primary Lipogranuloma of the Forehead. Am J Otolaryngol. 1995; 16:354–6.
crossref
17. Ben Simon GJ, Huang L, Nakra T. . Intralesional triamcinolone acetonide injection for primary and recurrent chalazia: is it really effective? Ophthalmology. 2005; 112:913–7.

Figure 1
. Non-tender firm left upper lid mass with scaly skin eruption.
jkos-49-2001f1.tif
Figure 2
. CT finding showing mild soft tissue swelling with linear hyperdensity (*) in the left superior palpabral lesion.
jkos-49-2001f2.tif
Figure 3
. Intraoperative findings. * Whitish firm multiple nodules and scattered invasion of the surrounding tissue including the orbicularis oculi muscle. ** Piecemeal resection because en bloc resection was impossible.
jkos-49-2001f3.tif
Figure 4
. This lesion is composed of variably sized empty spaces (lipid) surrounded by macrophages and fibrosis. * Variably sized lipogranuloma invading the orbicularis oculi muscle. ** Macrophage infiltration and fibrosis.
jkos-49-2001f4.tif
Figure 5
. Postoperative 7 months: Decreased rough skin surface and color changes.
jkos-49-2001f5.tif
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