Sclerosing lipogranuloma of the orbit after periocular steroid injection

Purpose: To report the clinical and histopathologic findings of a large sclerosing lipogranuloma of the orbit arising after a sub-Tenon's corticosteroid injection. Design: Interventional case report and review of the literature. Methods: A complete ocular and systemic evaluation was performed on a 81-year-old patient, who developed a large orbital mass subsequent to a periocular corticosteroid injection producing proptosis, ptosis, and ocular motility impairment. The lesion was biopsied and submitted for histopathologic analysis. Main Outcome Measures: Orbital, computed tomography, and histopathologic findings. Results: Histopathologic examination revealed lipogranulomatous inflammation. Specifically, this type of reaction was consistent with a diagnosis of sclerosing lipogranuloma. Conclusions: It is extremely rare to find a large granulomatous orbital lesion arising subsequent to a periocular corticosteroid injection. Only one case has been reported in the English-language literature to date. It is important to include this type of lesion in the differential diagnosis of an orbital mass seen after the injection of periocular corticosteroids. Ophthalmology 2003;110:1841-1845 (C) 2003 by the American Academy of Ophthalmology.