안와전두골에 발생한 콜레스테롤 육아종 3예

Three Cases of Orbitofrontal Cholesterol Granuloma

Purpose: To report three cases of orbitofrontal cholesterol granuloma. Methods: The study subjects were three patients with chief complaints of proptosis and upgaze limitation of ocular movement. Exophthalmometric values were 4∼8 mm by Hertel exophthalmometer. Orbital CT and MRI scans were taken in all patients, and regarded as orbitofrontal cholesterol granuloma. In all cases, excisional biopsy was done through the lateral approach. Results: Orbital CT scan showed an isodense to hypodense, well-defined, homogeneous mass and osteolytic lesion in the adjacent superolateral bony orbit. Orbital MRI scan showed a mass with high signal intensity in both T1- and T2-weighted images. Histopathologically, the specimen showed numerous slits like cholesterol clefts surrounded by multinucleated, foreign body type, giant cells with hemosiderin pigments. Conclusions: Orbitofrontal cholesterol granuloma, although rare, has typical clinical and radiologic features. Surgical excision has a high success rate without recurrence.