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Herniated Orbital Fat

General

Herniated orbital fat is a rare benign condition. From the optic nerve to corneal limbus, a thin elastic membrane envelops the globe (Tenon capsule). This capsule is it surrounded by orbital fat, which fills the orbital socket and stabilizes globe motion:

Clinical features

  • Rarely causes an infraorbital mass lesion
  • Mean age 66 years, 90% men
  • Prolapse is usually into superotemporal quadrant or lateral canthus
  • Usually due to orbital fat herniation through a dehiscence in Tenon’s capsule
  • Manifests as unilateral or bilateral yellowish mass
  • Does not recur

Differential diagnosis

  • Pleomorphic lipoma: different clinical presentation, aggregates of bland spindle cells, floret cells and wiry collagen
  • Well differentiated liposarcoma: different clinical presentation, enlarged hyperchromatic cells within fibrous septae

BEFORE & AFTER

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