J Korean Ophthalmol Soc.  2008 Mar;49(3):499-502. 10.3341/jkos.2008.49.3.499.

Subcutaneous Fat Necrosis of the Lower Eyelid Associated with Anemia

• Lim JW
• Kim YJ

• KMID: 2211325
• DOI: http://doi.org/10.3341/jkos.2008.49.3.499

Abstract

PURPOSE: Subcutaneous fat necrosis is rare. To our knowledge, there is no report of subcutaneous fat necrosis on the lower eyelid. We report a case of subcutaneous fat necrosis of the lower eyelid related to anemia.
CASE SUMMARY
A 52-year-old female patient presented with palpable masses in both lower eyelids that had persisted for the past year. The thin, shallow, plaque-like mass with a well-demarcated border was palpated on the subcutaneous tissue of both lower eyelids. There was no tenderness or signs of inflammation. histopathologically, there were variously sized fat vacuoles with mild cellular infiltration. The mass was determined to be caused by subcutaneous fat necrosis. The patient had no unusual past history except a total gastrectomy 2 years previously. We performed a blood test and detected chronic anemia.
CONCLUSIONS
We report a case of chronic subcutaneous fat necrosis related to anemia. When clinicians detect the subcutaneous fat necrosis, a work-up on hematological factors affecting lipid metabolism should be performed.

Keyword

Anemia; Eyelid; Subcutaneous fat necrosis

MeSH Terms

Anemia
Eyelids
Female
Gastrectomy
Hematologic Tests
Humans
Inflammation
Lipid Metabolism
Middle Aged
Necrosis
Subcutaneous Fat
Subcutaneous Tissue
Vacuoles

Figure

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  Figure 1. Clinical photograph of the 52-year-old woman with a shallow plaque-shaped palpable mass on each lower eyelid (arrows).

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  Figure 2. Axial enhanced computed tomographic scan demonstrates a homogenous non-enhanced mass with soft tissue density in both the lower eyelid lesions (arrows).

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  Figure 3. Light micrograph of the incisional biopsy specimen from the right lower lid mass. Microscopically, there are variable sized-fat vacuoles with mild infiltration of lymphocytes, foamy histiocytes and giant cells (arrows). (H&E, ×200)

Reference

References

1. Burden AD, Krafchik BR. Subcutaneous fat necrosis of the newborn: a review of 11 cases. Pediatr Dermatol. 1999; 16:384–7.

2. Tan PH, Lai LM, Carrington EV, et al. Fat necrosis of the breast: review. Breast. 2006; 15:313–8.

3. Marsh Rde W, Hagler KT, Carag HR, Flowers FP. Pancreatic panniculitis. Eur J Surg Oncol. 2005; 31:1213–5.

4. Hicks MJ, Levy ML, Alexander J, Flaitz CM. Subcutaneous fat necrosis of the newborn and hypercalcemia: case report and review of the literature. Pediatr Dermatol. 1993; 10:271–6.

5. Vonk J, Janssens PM, Demacker PN, Folkers E. Subcutaneous fat necrosis in a neonate in association with aberrant plasma lipid and lipoprotein values. J Pediatr. 1993; 123:462–4.

6. Varan B, Gurakan B, Ozbek N, Emir S. Subcutaneous fat necrosis of the newborn associated with anemia. Pediatr Dermatol. 1999; 16:381–3.

7. Cook JS, Stone MS, Hansen JR. Hypercalcemia in association with subtutaneous fat necrosis of the newborn: studies of calcium regulating hormones. Pediatrics. 1992; 90:93–6.

8. Sharata H, Postellon DC, Hashimoto K. Subcutaneous fat necrosis, hypercalcemia, and prostaglandin E. Pediatr Dematol. 1995; 12:43–7.

9. Hanif Z, Ahmad M. Subcutaneous fat necrosis presenting as a large mass. Eur J Emerg Med. 2006; 13:106–7.

10. Bilgen IG, Ustun EE, Memis A. Fat necrosis of the breast: clinical, mammographic and sonographic features. Eur J Radiol. 2001; 39:92–9.

11. Avram MM, Avram AS, James WD. Subcutaneous fat in normal and diseased states: 1. introduction. J Am Acad Dermatol. 2005; 53:663–70.

12. Scales JW, Krowchuk DP, Schwartz RP, Jorizzo JL. An infant with firm, fixed plaques. Arch Dermatol. 1998; 134:425–6.

13. Tran JT, Sheth AP. Complications of subcutaneous fat necrosis of the newborn: a case report and review of the literature. Pediatr Dermatol. 2003; 20:257–61.

14. White WL, Wieselthier JS, Hitchcock MG. Panniculitis: recent developments and observations. Semin Cutan Med Surg. 1996; 15:278–99.

15. Requena L. Normal subcutaneous fat, necrosis of adipocytes and classification of the panniculitides. Semin Cutan Med Surg. 2007; 26:66–70.