Herniated Orbital Fat
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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:
- Prolapse of subconjunctival intraconal orbital fat
- First described in pathology literature in 2007 (Am J Surg Pathol 2007;31:193)
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
