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Cholesterol granuloma of the orbit: an atypical presentation.

Rizvi SA, Hasan M, Alam MS - Indian J Ophthalmol (2014)

Bottom Line: A large mass was felt beneath the bony orbital margin in the superomedial quadrant of the left orbit.Computerized tomography (CT) scan revealed an extraconal superomedial, heterogeneous enhancing mass which was isodense with brain and pushing the globe inferolaterally and anteriorly.An appropriate intervention in time carries a good prognosis with almost no recurrence.

View Article: PubMed Central - PubMed

Affiliation: Institute of Ophthalmology, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India.

ABSTRACT
Cholesterol granuloma is a rare, well-defined lesion of the orbit. In the orbit, diploe of the frontal bone is involved almost exclusively. We report an atypical case of cholesterol granuloma involving superomedial quadrant of orbit. A 42-year-old male presented with progressive, painless, proptosis with infero-temporal displacement of left eye. A large mass was felt beneath the bony orbital margin in the superomedial quadrant of the left orbit. Computerized tomography (CT) scan revealed an extraconal superomedial, heterogeneous enhancing mass which was isodense with brain and pushing the globe inferolaterally and anteriorly. Excision biopsy of the tumor revealed the typical features of a cholesterol granuloma without any epithelial elements. Cholesterol granuloma of the orbit is a rare entity, but it can be diagnosed and differentiated from other lesions of the superior orbit by its characteristic clinical, radiological and histopathological features. An appropriate intervention in time carries a good prognosis with almost no recurrence.

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Photomicrograph showing (a) cholesterol crystals surrounded by foreign body giant cells, packed macrophages, lymphocytes and extravasated RBCs (H and E, ×100). (b) Magnified view of cholesterol crystals with cholesterol clefts (H and E, ×400)
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Figure 3: Photomicrograph showing (a) cholesterol crystals surrounded by foreign body giant cells, packed macrophages, lymphocytes and extravasated RBCs (H and E, ×100). (b) Magnified view of cholesterol crystals with cholesterol clefts (H and E, ×400)

Mentions: The mass with golden brown content was completely excised by anterior orbitotomy approach through an upper eyelid crease incision. Curettage of the frontal bone was also done to remove the residual granulomatous material. Histopathological examination shows cholesterol crystals surrounded by foreign body giant cells, packed macrophages, lymphocytes and extravasated RBCs [Fig. 3a and b]


Cholesterol granuloma of the orbit: an atypical presentation.

Rizvi SA, Hasan M, Alam MS - Indian J Ophthalmol (2014)

Photomicrograph showing (a) cholesterol crystals surrounded by foreign body giant cells, packed macrophages, lymphocytes and extravasated RBCs (H and E, ×100). (b) Magnified view of cholesterol crystals with cholesterol clefts (H and E, ×400)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061677&req=5

Figure 3: Photomicrograph showing (a) cholesterol crystals surrounded by foreign body giant cells, packed macrophages, lymphocytes and extravasated RBCs (H and E, ×100). (b) Magnified view of cholesterol crystals with cholesterol clefts (H and E, ×400)
Mentions: The mass with golden brown content was completely excised by anterior orbitotomy approach through an upper eyelid crease incision. Curettage of the frontal bone was also done to remove the residual granulomatous material. Histopathological examination shows cholesterol crystals surrounded by foreign body giant cells, packed macrophages, lymphocytes and extravasated RBCs [Fig. 3a and b]

Bottom Line: A large mass was felt beneath the bony orbital margin in the superomedial quadrant of the left orbit.Computerized tomography (CT) scan revealed an extraconal superomedial, heterogeneous enhancing mass which was isodense with brain and pushing the globe inferolaterally and anteriorly.An appropriate intervention in time carries a good prognosis with almost no recurrence.

View Article: PubMed Central - PubMed

Affiliation: Institute of Ophthalmology, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India.

ABSTRACT
Cholesterol granuloma is a rare, well-defined lesion of the orbit. In the orbit, diploe of the frontal bone is involved almost exclusively. We report an atypical case of cholesterol granuloma involving superomedial quadrant of orbit. A 42-year-old male presented with progressive, painless, proptosis with infero-temporal displacement of left eye. A large mass was felt beneath the bony orbital margin in the superomedial quadrant of the left orbit. Computerized tomography (CT) scan revealed an extraconal superomedial, heterogeneous enhancing mass which was isodense with brain and pushing the globe inferolaterally and anteriorly. Excision biopsy of the tumor revealed the typical features of a cholesterol granuloma without any epithelial elements. Cholesterol granuloma of the orbit is a rare entity, but it can be diagnosed and differentiated from other lesions of the superior orbit by its characteristic clinical, radiological and histopathological features. An appropriate intervention in time carries a good prognosis with almost no recurrence.

Show MeSH
Related in: MedlinePlus