Orbital cholesterol granuloma: A report and discussion of orbital findings

Andrew J. Rong, Benjamin P. Erickson, Nathan W. Blessing, Sander R. Dubovy, Bradford W. Lee

Research output: Contribution to journalArticle

Abstract

Purpose: To report a case of orbital cholesterol granuloma and discuss the orbital findings seen in this entity. Observation: A 38-year-old male presented with an 8-month history of progressive left upper lid ptosis and hypoglobus. Clinical examination was significant for 3 mm of hypoglobus and restricted supraduction in the left eye. Contrasted computed tomography imaging revealed a well-circumscribed lesion in the superotemporal orbit causing extensive bone erosion that appeared to arise from the lacrimal gland. An incisional biopsy was performed, and histopathological evaluation demonstrated fibrovascular tissue surrounding a mixture of histiocytes and cholesterol clefts, consistent with a cholesterol granuloma. Conclusions and importance: Orbital cholesterol granulomas are rare lesions that are predominantly found in the superotemporal orbit. These lesions can be associated with marked bony changes in the superotemporal fossa that can be mistaken for a lacrimal gland neoplasm; however, bony erosion is a hallmark of this lesion and should be considered on the differential diagnosis of any lacrimal gland mass with extensive bony erosion.

Original languageEnglish (US)
Article number100468
JournalAmerican Journal of Ophthalmology Case Reports
Volume15
DOIs
StatePublished - Sep 1 2019
Externally publishedYes

Fingerprint

Granuloma
Lacrimal Apparatus
Cholesterol
Orbit
Histiocytes
Differential Diagnosis
Tomography
Observation
Biopsy
Bone and Bones
Neoplasms

Keywords

  • Blood cyst
  • Cholesteatoma
  • Hematic cyst
  • Hematocele
  • Orbitofrontal choletesterol granuloma
  • Xanthomatosis of the orbit

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Orbital cholesterol granuloma : A report and discussion of orbital findings. / Rong, Andrew J.; Erickson, Benjamin P.; Blessing, Nathan W.; Dubovy, Sander R.; Lee, Bradford W.

In: American Journal of Ophthalmology Case Reports, Vol. 15, 100468, 01.09.2019.

Research output: Contribution to journalArticle

Rong, Andrew J. ; Erickson, Benjamin P. ; Blessing, Nathan W. ; Dubovy, Sander R. ; Lee, Bradford W. / Orbital cholesterol granuloma : A report and discussion of orbital findings. In: American Journal of Ophthalmology Case Reports. 2019 ; Vol. 15.
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AB - Purpose: To report a case of orbital cholesterol granuloma and discuss the orbital findings seen in this entity. Observation: A 38-year-old male presented with an 8-month history of progressive left upper lid ptosis and hypoglobus. Clinical examination was significant for 3 mm of hypoglobus and restricted supraduction in the left eye. Contrasted computed tomography imaging revealed a well-circumscribed lesion in the superotemporal orbit causing extensive bone erosion that appeared to arise from the lacrimal gland. An incisional biopsy was performed, and histopathological evaluation demonstrated fibrovascular tissue surrounding a mixture of histiocytes and cholesterol clefts, consistent with a cholesterol granuloma. Conclusions and importance: Orbital cholesterol granulomas are rare lesions that are predominantly found in the superotemporal orbit. These lesions can be associated with marked bony changes in the superotemporal fossa that can be mistaken for a lacrimal gland neoplasm; however, bony erosion is a hallmark of this lesion and should be considered on the differential diagnosis of any lacrimal gland mass with extensive bony erosion.

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