J Korean Ophthalmol Soc.  2013 Dec;54(12):1918-1922.

A Case of Orbital Organizing Hematoma Presenting as a Chalazion

• Kim EW
• Lee MJ

Abstract

PURPOSE
Organizing hematomas (hematic pseudocysts) of the orbit are usually the consequence of direct blunt trauma and are important in the differential diagnosis of orbital cystic lesion. Herein, we report a case of orbital organizing hematoma masquerading as a chalazion.
CASE SUMMARY
A 12-year-old female visited our clinic complaining of left lower eyelid swelling. CT scan and MR imaging showed a mass detected in the inferomedial space of her left orbit, which did not invade the adjacent tissue. Excisional biopsy of the orbital mass was performed. Histological examination showed the accumulation of blood-breakdown products within a thick fibrous capsule without epithelial or endothelial lining. The mass was diagnosed as an organizing hematoma.
CONCLUSIONS
An orbital organizing hematoma can present, although rare, as a chalazion-like eyelid mass. Careful clinical and radiological examinations can help in making a differential diagnosis.

Keyword

Chalazion; Hematic pseudocyst; Orbit; Organizing hematoma

MeSH Terms

Biopsy
Chalazion*
Child
Diagnosis, Differential
Eyelids
Female
Hematoma*
Humans
Magnetic Resonance Imaging
Orbit*
Tomography, X-Ray Computed

Figure

• 

  Figure 1. (A, B) External photographs show left lower eyelid swelling and partially protruded mass. At 1 month after surgery, the patient has no evidence of recurrence.

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  Figure 2. Axial view of T1-weighted image (A) and co-ronal view of T2-weighted image (B) demonstrate 1.7 ×1.7 cm sized well-demarcated cystic mass in the inferior medial extraconal space of the left orbit. The mass shows high signal intensity in both T1 and T2-weighted images. There is maxillary sinusitis. (C) The mass shows poor enhancement.

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  Figure 3. The gross appearance of the excised mass. The mass showed dark reddish color and had smooth surface. The size was 25 × 18 × 15 mm.

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  Figure 4. Microscopic appearance of organizing hematoma (A) The tumor was composed of thick fibrous capsule lacking an epithelial lining, and blood clots (H&E, ×12.5). (B) The blood-breakdown products and inflammatory cells are observed. (H&E, ×100).

Reference

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