Huh Jungah, Yang Sungwon, Park Jinhwan, Lee Hwa, Baek Sehyun
Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.
J Craniofac Surg. 2019 May/Jun;30(3):808-810. doi: 10.1097/SCS.0000000000005113.
A 45-year-old female came to the clinic complaining of periorbital swelling and ptosis on the left upper eyelid that had started 6 months previously. She had received an autologous fat injection in the forehead 6 months prior, and there was no other ophthalmologic history. There were no abnormal findings, including pupil, extraocular movement, or fundus examination. There was eyebrow elevation of the left upper eyelid, and the marginal reflex distance 1 was 1 mm on the left eye compared to 4 mm on the right eye. There were a 2-cm-sized round and firm mass on the left upper eyelid that was not accompanied by tenderness. Orbital computed tomography showed heterogeneous infiltration with an ill-defined margin. Excisional biopsy and levator advancement were performed on the left upper eyelid, and histological findings showed chronic granulomatous inflammation with foreign body reaction and fat necrosis.A complete history for patient presentation with autologous fat injection is important when a periorbital mass is encountered clinically because granulomatous inflammation of the eyelid may occur after autologous fat injection in the forehead and can be related to migration of the injected fat.
一名45岁女性前来诊所，主诉左上眼睑眶周肿胀和上睑下垂，症状始于6个月前。她在6个月前接受了前额自体脂肪注射，无其他眼科病史。包括瞳孔、眼球运动或眼底检查在内均无异常发现。左上眼睑眉部抬高，左眼的边缘反射距离为1毫米，而右眼为4毫米。左上眼睑有一个2厘米大小的圆形坚实肿块，无压痛。眼眶计算机断层扫描显示不均匀浸润，边界不清。对左上眼睑进行了切除活检和提上睑肌前移术，组织学检查结果显示为伴有异物反应和脂肪坏死的慢性肉芽肿性炎症。临床上遇到眶周肿块时，了解患者自体脂肪注射的完整病史很重要，因为前额自体脂肪注射后可能会发生眼睑肉芽肿性炎症，且可能与注射脂肪的迁移有关。
