Dept. of Ophthalmology, University of Freiburg
Purpose: Patients who previously underwent lavage procedures or surgery of their paranasal sinus might develop lid tumors after a quite variable period of time. We report such a case here.
Method: The now 47-year old female patient underwent a lavage and endonasal sinus surgery due to chronic sinusitis maxillaris, sphenoidalis et ethmoidalis in 1973. Three months and 15 years later, respectively, she developed tumors of her lower and upper lids, which were surgically removed.The specimens were fixed in 4% formalin solution, dehydrated and embedded in paraffin. 3 micrometer sections were cut and stained with Hematoxylin-Eosin (HE) und Periodic Acid Schiff (PAS).
Results: Histologically a chronic granulomatous reaction on fat with numerous giant cells, epithelioid cells, lymphocytes and plasma cells was found in both specimens.
Conclusions: The histological finding of a lipogranuloma in the lid always include the differential diagnosis of a paraffin-induced granuloma and the patient should be inquired about previous paranasal sinus procedures. Our case shows that paraffin-induced granulomas can (re)occur after a very long time intervall of 15 years postoperatively.
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