Soft Tissue Tumors - Subconjunctival herniated orbital fat

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Soft Tissue Tumors

Adipose tissue

Subconjunctival herniated orbital fat

Reviewer: Vijay Shankar, M.D. (see Reviewers page)
Revised: 11 November 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● 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
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● 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
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● Infant with small yellow mass in right eye (Eur J Pediatr 2010;169:1427)
● 52 year old woman with inferonasal mass (Nihon Ganka Gakkai Zasshi 2008;112:1085)

Clinical images
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Various images

Micro description
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● 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
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● Floret cells - CD34 and vimentin
● Lochkern cells - CD34, vimentin and S100

Differential diagnosis
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● 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

End of Soft Tissue Tumors > Adipose tissue > Subconjunctival herniated orbital fat

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