J Korean Ophthalmol Soc > Volume 57(9); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(9):1465-1471.
DOI: https://doi.org/10.3341/jkos.2016.57.9.1465    Published online September 15, 2016.
Adult-Onset Asthma and Periocular Xanthogranuloma in a 75-Year-Old Man.
Seung Wan Nam, Ju Hyang Lee, Kyung In Woo, Yoon Duck Kim
1Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ydkimoph@skku.edu
2Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
성인 천식 동반 눈주변 황색육아종 1예
남승완1⋅이주향2⋅우경인1⋅김윤덕1
성균관대학교 의과대학 삼성서울병원 안과학교실1, 울산대학교 의과대학 울산대학교병원 안과학교실2
Correspondence:  Yoon-Duck Kim, MD, PhD
Email: ydkimoph@skku.edu
Received: 9 June 2016   • Revised: 11 July 2016   • Accepted: 19 August 2016
Abstract
PURPOSE
Adult xanthogranulomatous disease of the orbit including adult-onset asthma and periocular xanthogranuloma is rare. To the best of the author's knowledge, adult-onset asthma and periocular xanthogranuloma have not been previously reported in Korea. CASE SUMMARY: A 75-year-old man presented with a 15-year history of progressive bilateral yellowish eyelid mass. He had a history of adult-onset asthma diagnosed 13 years ago. On ocular examination, there were firm yellowish bilateral eyelid masses and ptosis markedly on the right eye. Exophthalmos was noted in the right eye. There were exotropia, hypertropia, and gaze restriction of the right eye. Orbit magnetic resonance imaging demonstrated an ill-defined bilateral infiltrative orbital mass extending to the lid, lacrimal gland, and sinuses. A right orbital mass extended to the posterior orbit. Enlargement of extraocular muscles was also noted in the right eye. Left upper eyelid mass debulking surgery was performed. A combination therapy of azathioprine and prednisolone was started. Mass debulking surgeries of the right upper and lower eyelids were performed. CONCLUSIONS: Adult-onset asthma and periocular xanthogranuloma is known as a refractory disease. Combination therapy with azathioprine and steroid therapy with mass debulking surgery is a good treatment option for adult-onset asthma and periocular xanthogranuloma.
Key Words: Adult-onset asthma and periocular xanthogranuloma;Adult xanthogranulomatous disease;Azathioprine;Immunotherapy;Xanthoma cell
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