A Case of Eyelid Paraffinoma Misdiagnosed as a Chalazion

ABSTRACT

PURPOSE: Paraffinoma is a granulomatous reaction to paraffin or oily substances. We report delayed diagnosis of paraffinoma that was misdiagnosed as chalazion. CASE SUMMARY: A 49-year-old male presented with masses, swelling, and erythema in the right lower eyelid, masses and swelling in the right upper eyelid, and intermittent conjunctival injection that had appeared 3 months ago. The patient admitted having received paraffin injection to the right lateral canthal area and nasal bridge for cosmetic purposes by non-medical personnel 17 years prior to presentation. The mass showed partial response to intralesional triamcinolone injection but did not respond to systemic steroid. CONCLUSIONS: Paraffinoma can present diagnostic confusion given its protracted latency period and discordance of injection area and mass location. Detailed history taking is required and the possibility of paraffinoma should be considered for mass lesions of the eyelid.