Soft tissue
Adipose tissue
Subconjunctival herniated orbital fat

Author: Vijay Shankar, M.D. (see Authors page)

Revised: 8 August 2016, last major update August 2012

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Subconjunctival herniated orbital fat

Definition / General
  • Prolapse of subconjunctival intraconal orbital fat
  • First described in pathology literature in 2007 (Am J Surg Pathol 2007;31:193)
  • Not a WHO diagnosis
Clinical Features
  • Rarely causes an intraorbital 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
Case Reports
Micro Description
  • Mature fat, fibrous septa without hyperchromatic cells
  • Adipocytes with intranuclear vacuoles (Lochkern cells) and floret cells (multinucleated giant cells with wreath like pattern of normal nuclei)
  • Variable histiocytes, lymphocytes, plasma cells and mast cells
Positive Stains
Differential Diagnosis