A woman with a peri-orbital mass.

A 54-year-old Chinese woman with a history of alcoholic cirrhosis and hypersplenism presented in 2003 with bilateral peri-orbital, malar, and glabellar swelling (Fig 1). She had a history of milder glabellar swelling 7 years ago. An incisional biopsy of the lesion taken at that time showed granulomatous inflammation. She subsequently failed to attend for follow-up. She came back when she discovered the lesions had enlarged and progressed to her lower eyelids and cheeks.