Hughes Joshua D, Jacob Jeffery T, Garrity James A, Salomao Diva R, Link Michael J
Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
Department of Ophthalmology, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
World Neurosurg. 2016 Mar;87:355-61. doi: 10.1016/j.wneu.2015.11.095. Epub 2015 Dec 24.
Primary orbitofrontal cholesterol granuloma (OFCG) is rare. We present 4 cases of OFCG and a systematic literature review to examine patient characteristics, presentation, treatment, and outcome.
Our institutional records were reviewed for OFCG cases. A systematic literature review was performed using PubMed. Inclusion criteria were English-language studies with pathology-proven OFCG. Exclusion criteria were OFCG in a craniofacial sinus. The search-string yielded 172 results. Fifty studies met inclusion criteria (39 primary and 11 secondary), and relevant data were reviewed.
Four patients underwent surgery for OFCG at our institution (ages 53, 43, 34, and 43; 3 females, 1 male). All patients were treated with surgery using a tailored frontal-orbital craniotomy with complete resection. There was no recurrence at 12-month, 4-year, 10-year, and 22-year follow-up for each patient, respectively. Systematic review of the literature identified 172 patients. Follow-up was available in 93 patients (54.1%) with a mean follow-up of 43.3 months. Seven patients demonstrated recurrence at a median of 36 months following surgery. Combining our 4 cases with the 93 patients with reported follow-up gives a recurrence rate of 7% (7/97). Recurrence was associated with incomplete resection and an orbital approach.
Thorough removal of the lesion with curettage of the boney cavity is recommended for OFCG. Recurrence following complete removal of OFCG is rare.
原发性眶额胆固醇肉芽肿（OFCG）较为罕见。我们报告4例OFCG病例，并进行系统的文献综述，以研究患者特征、临床表现、治疗方法及预后。
我们查阅了本机构的记录以查找OFCG病例。使用PubMed进行系统的文献综述。纳入标准为经病理证实的OFCG的英文研究。排除标准为颅面窦中的OFCG。检索词共产生172条结果。50项研究符合纳入标准（39项原发性和11项继发性），并对相关数据进行了综述。
我们机构有4例患者接受了OFCG手术（年龄分别为53岁、43岁、34岁和43岁；3名女性，1名男性）。所有患者均采用定制的额眶开颅术进行手术，以实现完全切除。每位患者在12个月、4年、10年和22年的随访中均未复发。对文献的系统综述共纳入172例患者。93例患者（54.1%）有随访数据，平均随访时间为43.3个月。7例患者在术后中位时间36个月出现复发。将我们的4例病例与93例有随访报告的患者合并后，复发率为7%（7/97）。复发与切除不完全及采用眶入路有关。
对于OFCG，建议彻底清除病变并刮除骨腔。OFCG完全切除后复发罕见。
