[Necrobiotic xanthogranuloma. Differential diagnosis, treatment and systemic involvement. Case report]

A 48-year-old male was referred to our hospital for further evaluation of eyelid edema with bilateral yellowish ulcerated nodules. Suspecting a xanthogranulomatosis, imaging tests and biopsy were performed with diagnosis of necrobiotic xanthogranuloma. IgG monoclonal gammapathy was diagnosed in a systemic study. Systemic corticosteroids and cyclosporine were initiated unsuccessfully; therefore intra-lesional injections of triamcinolone were started, which controlled the orbital disease.

Necrobiotic xanthogranuloma is a rare condition that usually affects the eyelids and anterior orbit. Its diagnosis is important as it is associated with malignant lymphoproliferative processes. Intra-lesional corticosteroids were effective in our patient.