Bilateral Epibulbar Xanthomas—A Case Report

Purpose: To report bilateral epibulbar xanthomatous lesions in an adult with a normal serum lipid profile and no cutaneous or systemic features of a histiocytic disease. Methods: Clinicopathologic report. Results: A 44-year-old man presented with gradually enlarging yellow epibulbar masses in both eyes. The lesions had recurred after excisions performed 2 years previously. Systemic evaluation was normal. Excisional biopsies were performed, and histological examination revealed numerous foamy histiocytes with scattered Touton giant cells and lymphocytes. No recurrence was observed after 1 year of follow-up. Conclusion: Xanthomatous epibulbar lesions are exceedingly rare and may occur as an isolated finding. Evaluation should be directed toward detecting underlying non-Langerhans cell histiocytic diseases and disorders of lipid metabolism. Recurrent lesions may be successfully treated by surgical excision.