Cholesterol granuloma of the orbit: An atypical presentation

• Main Authors: Syed A R Rizvi, Mahboob Hasan, Mohammad S Alam
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2014-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Clinical profile; Indian population; optic neuritis treatment trial; optic neuritis; Decompression of the orbit; diplopia; orbit; thyroid exophthalmos; thyroid ophthalmopathy; Limbus incision; subconjunctival incision; sutureless manual small-incision cataract surgery; wound construction; Central retinal vein occlusion; intravitrealbevacizumab; intravitrealtriamcinolone acetonide; macular edema; Contrast sensitivity; fixation; microperimeter; normative data; retinal sensitivity; Optical coherence tomography; optic disc pit; retinal detachment; retinoschisis; Homocysteine; retinal vein occlusion; visual impairment; Diabetic macular edema; monocyte chemoattractant protein-1; soluble intracellular adhesion molecule-1; vascular endothelial growth factor; Compressive optic neuropathy; humphrey visual field; ischemic optic neuropathy; multifocal visual evoked potential; Age; body mass index; gender; high density lipoprotein; intraocular pressure; lipid profiles; total cholesterol; triglyceride; Capsular tension ring; cataract; intraocular lens; myopia; phacoemulsification; posterior capsular opacification; Ethnicity; Indian; macular thickness; normative; retinal nerve fiber layer; Ocular torticollis; superior oblique palsy; surgery; Barriers to follow-up; pediatric cataract; visual outcome; Cataract; intracameral mydriatic solution; no preoperative mydriatic; Disc edema; neem oil; putamen; toxin-induced encephalopathy; Toxic Optic Neuropathy Secondary to Consumption of Neem Oil; Absent thumb; craniofacial defects; limbal dermoid; Nager syndrome; Keratitis; Rhodotorula sp; Polymerase chain reaction; Atypical; cholesterol granuloma
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2014;volume=62;issue=3;spage=344;epage=346;aulast=Rizvi

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.