Xanthogranuloma formation after endoscopic sinus surgery : A
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Although xanthogranuloma is known to be related to trauma or mucosa, possibly developing around a periorbital or oral lesion, xanthogranuloma related to sinusitis surgery has not been reported.

A 54-year-old man presented to our clinic complaining of pain and swelling in the right periorbital area. He had undergone endoscopic sinus surgery (ESS) for chronic sinusitis about 2 years prior to presentation. His orbits were severely swollen on postoperative day 2 after blowing his nose. Computed tomography (CT) showed that the patient had blowout fracture complications after the ESS and emphysema but no defects. The patient had not undergone any additional surgery or treatment. The swelling recurred over 2 years without any symptoms. However, the patient found a focal mass on his lower eyelid 6 months before revisiting our clinic. He denied any history of drug use, family history, including any relevant genetic information, and psychosocial history.

Physical examination of the patient found a soft, movable, and palpable mass approximately 1?cm in diameter on the right lower eyelid. Computed tomography revealed a 1-cm × 0.7-cm cystic mass in the right lower eyelid region and demonstrated the status after ESS. The mass was already localized, so we decided to examine it using a subciliary approach. A plastic surgeon performed the surgery and found a graish tan colored lipomatous mass on the right lower eyelid. The patient tolerated the surgery and was discharged afterward. The mass was completely excised and sent to the pathology laboratory. The histological examination found that there were some variable-sized fat-containing pseudocystic granulomas and the mass was consistent with xanthogranulomatous inflammation. The mass was benign and did not need further treatment. The patient completed 2 weeks of oral antibiotics and no recurrence was observed for 1?year.