Presentation
Right conjunctival fatty lesion.
Patient Data
Right conjunctival epibulbar small lesion of fat signal. It measures 3 x 7mm along its max TS & AP dimensions. It elicits a high signal on T1- & T2-weighted imaging with signal suppression on fat saturation sequences. The lesion is smoothly abutting the related lateral aspect of the globe. No connection to the intra-orbital fat.
On CT, the lesion shows fat density of mean attenuation -50 HU.
A clinical photograph of the patient shows the conjunctival fatty lesion in keeping with dermolipoma.
Case Discussion
Dermolipoma is one of the fat-containing epibulbar mass lesions of lateral canthal area beneath the temporal or superotemporal bulbar conjunctivae. This should be differentiated from subconjunctival fat prolapse as they have different radiological features and treatment strategies. Dermolipomas are congenital and more commonly seen in young patients in contrast to the subconjunctival fat prolapse which occurs in old age. Also, dermolipoma usually has non connection to the intra-orbital fat, unlike subconjunctival fat prolapse.
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