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Orbital fat herniation frequently presents as a prominent unilateral mass near the lateral canthus of the eye, where it poses a fundamental question: benign or malignant? As dermatologists, we will encounter this seldom-described benign mass. The differential diagnosis, pathophysiology, and treatment options are discussed in the context of a patient case.
A nonobese man in his 80s with a history of 10 nonmelanoma skin cancers was seen in the dermatology clinic for an annual skin examination. Examination revealed a 1-cm yellow, glistening nodule at the superotemporal quadrant of the left eye. The nodule was most prominent when the patient turned the gaze of the involved eye medially (Figure). The patient had been aware of the asymptomatic mass for approximately 1 year. It did not interfere with his vision. There was no history of infection, trauma, or surgery to the orbit or adjacent skin. Examination of the right eye did not reveal a similar finding.
Khalil D, King B. A Unilateral Orbital Mass. JAMA Dermatol. 2014;150(10):1115. doi:10.1001/jamadermatol.2014.405
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