Paraffinoma of the periorbit--a challenge for the oculoplastic surgeon

Five patients with a history of sinus surgery with nasal packing and postoperative hemorrhage developed nontender, firm tumors of the periorbit. There was no spontaneous regression. Surgical excision was difficult due to diffuse cellular infiltration and intracutaneous deposits, requiring reoperations in all patients. Histology showed a marked lipogranulomatous reaction to dispersed lipid material with fibrosis. Paraffinoma is a known complication of paraffin injection in dermatology and cosmetic surgery. Reports of it in the ophthalmic literature are rare. This series documents a late complication of sinus surgery, very probably due to the intraoperative nasal packing with paraffin-containing ointments.