J Korean Ophthalmol Soc.  2015 Dec;56(12):1965-1968. 10.3341/jkos.2015.56.12.1965.

A Case of Eyelid Paraffinoma Misdiagnosed as a Chalazion

• Kwon JY
• Han JS

• KMID: 2148762
• DOI: http://doi.org/10.3341/jkos.2015.56.12.1965

Abstract

PURPOSE
Paraffinoma is a granulomatous reaction to paraffin or oily substances. We report delayed diagnosis of paraffinoma that was misdiagnosed as chalazion.
CASE SUMMARY
A 49-year-old male presented with masses, swelling, and erythema in the right lower eyelid, masses and swelling in the right upper eyelid, and intermittent conjunctival injection that had appeared 3 months ago. The patient admitted having received paraffin injection to the right lateral canthal area and nasal bridge for cosmetic purposes by non-medical personnel 17 years prior to presentation. The mass showed partial response to intralesional triamcinolone injection but did not respond to systemic steroid.
CONCLUSIONS
Paraffinoma can present diagnostic confusion given its protracted latency period and discordance of injection area and mass location. Detailed history taking is required and the possibility of paraffinoma should be considered for mass lesions of the eyelid.

Keyword

Chalazion; Paraffin; Paraffinoma; Steroid

MeSH Terms

Chalazion*
Delayed Diagnosis
Erythema
Eyelids*
Humans
Latency Period (Psychology)
Male
Middle Aged
Paraffin
Triamcinolone
Paraffin
Triamcinolone

Figure

• 

  Figure 1. Changes of mass of right eyelid. (A) Photograph of the patient at initial visit. Irregular erythematous mass on right lower eyelid margin and swelling of right upper eyelid were shown. Swelling of nasal bridge was shown. (B) One week af-ter intralesional triamcinolone injection. Size of erythematous nodule of right lower eyelid decreased. (C) One month after the use of oral prednisolone. No significant changes were visible.

• 

  Figure 2. Histological image of the removed tissue. Histopa- thological examination of the excisional biopsy specimen re-vealed aggregates of small lymphocytes, plasma cells and his-tiocytes, surrounding acellular, eosinophilic, foamy foreign material (Hematoxylin and eosin stain, ×200).

Reference

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