Cholesterol granuloma of the orbit: An atypical presentation

• Published in: Indian journal of ophthalmology Vol. 62; no. 3; pp. 344 - 346
• Main Authors: Rizvi, Syed, Hasan, Mahboob, Alam, Mohammad
• Format: Journal Article
• Language: English
• Published: India Medknow Publications 01.03.2014; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Absent thumb; Adult; Age; Atypical; Barriers to follow-up; body mass index; Brief Communications; Capsular tension ring; Care and treatment; cataract; Central retinal vein occlusion; Cholesterol; cholesterol granuloma; Clinical profile; Compressive optic neuropathy; Contrast sensitivity; craniofacial defects; Decompression of the orbit; Diabetic macular edema; Diagnosis; Diagnosis, Differential; diplopia; Disc edema; Ethnicity; Eye diseases; fixation; gender; Granuloma; Granuloma, Foreign-Body - diagnosis; Granuloma, Foreign-Body - surgery; high density lipoprotein; Homocysteine; Humans; humphrey visual field; Indian; Indian population; intracameral mydriatic solution; intraocular lens; intraocular pressure; intravitrealbevacizumab; intravitrealtriamcinolone acetonide; ischemic optic neuropathy; Keratitis; limbal dermoid; Limbus incision; lipid profiles; macular edema; macular thickness; Male; microperimeter; monocyte chemoattractant protein-1; multifocal visual evoked potential; myopia; Nager syndrome; neem oil; no preoperative mydriatic; normative; normative data; Ocular torticollis; Ophthalmologic Surgical Procedures - methods; optic disc pit; optic neuritis; optic neuritis treatment trial; Optical coherence tomography; orbit; Orbital Diseases - diagnosis; Orbital Diseases - surgery; pediatric cataract; phacoemulsification; Photomicrography; Polymerase chain reaction; posterior capsular opacification; putamen; retinal detachment; retinal nerve fiber layer; retinal sensitivity; retinal vein occlusion; retinoschisis; Rhodotorula sp; soluble intracellular adhesion molecule-1; subconjunctival incision; superior oblique palsy; surgery; sutureless manual small-incision cataract surgery; thyroid exophthalmos; thyroid ophthalmopathy; Tomography, X-Ray Computed; total cholesterol; Toxic Optic Neuropathy Secondary to Consumption of Neem Oil; toxin-induced encephalopathy; triglyceride; vascular endothelial growth factor; visual impairment; visual outcome; wound construction; India; cholesterol granuloma; Atypical; orbit
• ISSN: 0301-4738; 1998-3689
• DOI: 10.4103/0301-4738.111187

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.