Eyelid lipomas: a case report and review of the literature

Eyelid Lipoma

Purpose: To report a rare case of eyelid lipoma. Case summary: A 41-year-old female presented with a palpable mass in her left upper eyelid. Diffuse hard mass was palpable at preaponeurotic fat layer of left upper eyelid, and there was no inflammatory sign. Under local anesthesia, a left upper eyelid mass partial excision was performed and a biopsy specimen was collected. The mass was yellower and harder than surrounding normal eyelid fat. A lipoma was diagnosed based on histopathological findings such as proliferation of mature adipocytes. Conclusions: Lipoma is a benign tumor commonly found around trunk and limbs, but rarely occurs at eyelid. Eyelid lipoma should be considered as a differential diagnosis of diffuse mass at eyelid fat layer. Diagnosis and treatment can be achieved by partial excision and histopathological examination.

Diaphragmatic Lipoma in a Woman with Rheumatoid Arthritis: A Case Report and Literature Review

Patient: Female, 52-year-old

Final Diagnosis: Diaphragmatic lipoma

Symptoms: Shortness of breath

Medication: —

Clinical Procedure: CT scan

Specialty: Radiology • Rheumatology

Diagnosis and treatment of upper eyelid lipoma: A case report

Purpose

Presentation of a rare lesion: a case of upper eyelid lipoma,

Observations

A 76-year-old otherwise healthy woman presented with a right upper eyelid swelling. Her medical history was recorded. On ophthalmologic examination a soft, non-ulcerated and not well-circumscribed mass was evident. An ultrasonography examination was carried out showing a hyperechoic non capsulated mass situated between the superior orbital margin and the orbicularis oculi muscle.

Conclusions and Importance

Eyelid lipomas must be differentiated from herniated orbital fat, cystic lesions, tumours, and the lacrimal gland.

A pre-operative differential diagnosis of eyelid lipoma can be done through medical history, ophthalmologic, and ultrasonography examinations. Nevertheless, in case of doubt a magnetic resonance imaging (MRI) should be performed to assess a possible orbital involvement and to plan for the right surgical procedure to be performed.

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.

Pathology of eyelid tumors

The eyelids are composed of four layers: skin and subcutaneous tissue including its adnexa, striated muscle, tarsus with the meibomian glands, and the palpebral conjunctiva. Benign and malignant tumors can arise from each of the eyelid layers. Most eyelid tumors are of cutaneous origin, mostly epidermal, which can be divided into epithelial and melanocytic tumors. Benign epithelial lesions, cystic lesions, and benign melanocytic lesions are very common. The most common malignant eyelid tumors are basal cell carcinoma in Caucasians and sebaceous gland carcinoma in Asians. Adnexal and stromal tumors are less frequent. The present review describes the more important eyelid tumors according to the following groups: Benign and malignant epithelial tumors, benign and malignant melanocytic tumors, benign and malignant adnexal tumors, stromal eyelid tumors, lymphoproliferative and metastatic tumors, other rare eyelid tumors, and inflammatory and infections lesions that simulate neoplasms.

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.