Intramuscular lipoma of the eyelid: a case report

Preseptal Upper Eyelid Lipoma

Superficial subcutaneous lipomas are benign, slow-growing neoplasms comprised mature adipose cells that may be surrounded by a fibrous tissue capsule. While found commonly on the body, simple lipomas are rarely described in the eyelids. Reports of two eyelid lipomas in the literature describe the anatomy to be posterior to the orbital septum. The presenting authors report the case of a simple lipoma of the eyelid found fully in the preseptal plane. Lipomas can occur anterior to the orbital septum and should be considered in the differential when presented with a painless, slow-growing eyelid mass in adults.

Unilateral Pleomorphic Lipoma of the Eyebrow

AIM

Epithelial and soft tissue tumours of the eyebrow skin and subcutis are rare occurrences. We describe an unusual eyebrow subcutis mass in a 65-year-old female.

METHODS

A 65-year-old female presented with an 8- to 9-month history of a painless swelling over the right eyebrow that was sausage-shaped. The clinical differential diagnosis included neurofibroma/schwannoma, cyst, prolapsed fat or metastasis. The lesion was excised.

RESULTS

The histology revealed a lesion composed of rope-like collagen, some spindle cells, mature adipocytes and hyperchromatic multi-nucleate floret cells. The spindle and multi-nucleate floret cells showed immunohistochemical positivity for CD34. The features were of a primary pleomorphic lipoma.

CONCLUSIONS

This is the first reported case of a pleomorphic lipoma of the eyebrow subcutis. We discuss the clinical and histological differential diagnosis, especially related to histological conditions with which pleomorphic lipoma can be confused, such as well-differentiated liposarcoma.

Eyelid lipomas: a case report and review of the literature

Simple lipomas of the eyelid are rare. We present a case of a 61-year-old man, who presented with 6 months of a slowly worsening blepharoptosis. On examination, that patient was noted to have a palpable, soft mass in the medial left upper eyelid. Histopathological examination of the mass revealed mature adipose tissue most consistent with lipoma. Simple lipomas of the eyelid are very unusual but should be considered in the differential diagnosis of patients presenting with mechanical ptosis.

Intramuscular lipoma of the superior oblique muscle

We describe a rare intramuscular infiltrating lipomatous tumor affecting the superior oblique muscle. A 37-year-old female presented with eyelid swelling, proptosis and motility disturbance. Imaging studies revealed enlargement of the superior oblique muscle with a fat-density infiltrating lesion within its belly. The clinical and radiologic findings suggested a cystic or necrotic lesion. Biopsy showed an infiltrative tumor consisting of adipocytes with included degenerated muscle fibers. Histologic features were consistent with a benign intramuscular lipoma, rather than the more aggressive well-differentiated liposarcoma. A review of the literature found three previously described periorbital cases, two in the eyelid, and one in the anterior orbit. Lipomas are common tumors that usually do not cause functional impairment but are very rare in the orbit. Intramuscular lipoma is a rare subtype that can result in significant morbidity. Enlargement of an extraocular or periorbital muscle with a low-density infiltrating lesion should raise suspicion for this unusual tumor.