Orbital dermolipoma

Case contributed by Dalia Ibrahim

Presentation

Right conjunctival fatty lesion.

Patient Data

Age: 15 years
Gender: Female
mri
This study is a stack
Axial
T2
This study is a stack
Axial
T1
This study is a stack
Axial
T2
This study is a stack
Axial
STIR
This study is a stack
Coronal
T2
This study is a stack
Coronal
T1
This study is a stack
Coronal
STIR
This study is a stack
Sagittal
T2
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Info

Right conjunctival epibulbar small lesion of fat signal. It measures 3 x 7 mm along its max TS and AP dimensions. It elicits a high signal on T1- and T2-weighted imaging with signal suppression on fat saturation sequences. The lesion is smoothly abutting the related lateral aspect of the globe. No connection to the intra-orbital fat.

ct
This study is a stack
Axial
non-contrast
This study is a stack
Coronal
non-contrast
This study is a stack
Axial bone
window
This study is a stack
Coronal
bone window
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On CT, the lesion shows fat density of mean attenuation -50 HU.

Photograph
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A clinical photograph of the patient shows the conjunctival fatty lesion in keeping with dermolipoma.

Photograph
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A comparison between the clinical photo and selected axial images at the same level on CT and MRI.

Case Discussion

Dermolipoma is one of the fat-containing epibulbar mass lesions of lateral canthal area beneath the temporal or superotemporal bulbar conjunctivae. This should be differentiated from subconjunctival fat prolapse as they have different radiological features and  treatment strategies.

Dermolipomas are congenital and more commonly seen in young patients in contrast to the subconjunctival fat prolapse which occurs in old age. Also, dermolipoma usually has no connection to the intra-orbital fat, unlike subconjunctival fat prolapse.

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