A Case of Eyelid Paraffinoma Misdiagnosed as a Chalazion

Young Kwon Jin; Sang Han Ji

doi:10.3341/jkos.2015.56.12.1965

Journal List > J Korean Ophthalmol Soc > v.56(12) > 1010179

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Jin and Ji: A Case of Eyelid Paraffinoma Misdiagnosed as a Chalazion

Original Article

J Korean Ophthalmol Soc 2015;56(12):1965-1968.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.12.1965

A Case of Eyelid Paraffinoma Misdiagnosed as a Chalazion

Young Kwon Jin, M.D, Sang Han Ji, M.D

Department of Ophthalmology, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea

Address reprint requests to Ji Sang Han, MD Department of Ophthalmology, Myongji Hospital, #55 Hwasu-ro 14beon-gil, Deogyang-gu, Goyang 10475, Korea Tel: 82-31-810-6250, Fax: 82-31-810-0500 E-mail: jhan800@naver.com

Received 17 July 201526 August 2015 Accepted 22 October 2015

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

Paraffinoma is a granulomatous reaction to paraffin or oily substances. We report delayed diagnosis of paraffinoma that was misdiagnosed as chalazion.

Case summary

A 49-year-old male presented with masses, swelling, and erythema in the right lower eyelid, masses and swel-ling in the right upper eyelid, and intermittent conjunctival injection that had appeared 3 months ago. The patient admitted having received paraffin injection to the right lateral canthal area and nasal bridge for cosmetic purposes by non-medical personnel 17 years prior to presentation. The mass showed partial response to intralesional triamcinolone injection but did not respond to sys-temic steroid.

Conclusions

Paraffinoma can present diagnostic confusion given its protracted latency period and discordance of injection area and mass location. Detailed history taking is required and the possibility of paraffinoma should be considered for mass lesions of the eyelid.

Keywords: Chalazion, Paraffin, Paraffinoma, Steroid

References

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Figure 1.

Changes of mass of right eyelid. (A) Photograph of the patient at initial visit. Irregular erythematous mass on right lower eyelid margin and swelling of right upper eyelid were shown. Swelling of nasal bridge was shown. (B) One week af-ter intralesional triamcinolone injection. Size of erythematous nodule of right lower eyelid decreased. (C) One month after the use of oral prednisolone. No significant changes were visible.

Figure 2.

Histological image of the removed tissue. Histopa- thological examination of the excisional biopsy specimen re-vealed aggregates of small lymphocytes, plasma cells and his-tiocytes, surrounding acellular, eosinophilic, foamy foreign material (Hematoxylin and eosin stain, ×200).

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