Ogilvie syndrome after use of vincristine: tomographic findings

manifests clinically as a yellowish mass in the lateral corner of the eye, which becomes more evident with retropulsion of the globe. The imaging tests that can facilitate the diagnosis of subconjunctival fat prolapse are CT and magnetic resonance imaging (MRI) of the orbits, the most important radiological finding being that of a mass with fat density or fat-like signal intensity, respectively, located in the temporal aspect of the orbits, contiguous with intraconal fat. The treatment consists of transconjunctival excision, a simple, safe and effective surgical procedure. The rate of recurrence after transconjunctival excision is reported to be approximately 9%. Making a clinical diagnosis of subconjunctival fat prolapse is relatively easy. However, due to its rarity, it can be misdiagnosed as conjunctival dermolipoma, lymphoma, epidermoid cyst, or lacrimal gland prolapse. The main differential diagnosis is conjunctival dermolipoma, which consists of a benign lesion, usually present at birth, that affects young women, the mean age of such patients being 22 years. Although the clinical presentation of conjunctival dermolipoma is similar to that of the subconjunctival fat prolapse, the former is typically unilateral and fairly immobile. On CT and MRI, conjunctival dermolipoma presents as a crescent-shaped fatty mass in the temporal aspect of the orbit, not in communication with the intraconal fat. In conjunctival dermolipoma, surgical resection is indicated mainly for aesthetic purposes and tends to be more conservative. Although resection of a conjunctival dermolipoma is a simple procedure, there can be severe complications, including blepharoptosis, diplopia, and keratoconjunctivitis sicca. Therefore, a number of different surgical techniques aimed at a lowering the rate of complications and improving the aesthetic results have been described, including resection with conjunctival flap rotation. Cynthia Ramos Tejo1, Péricles Almeida da Costa1, Rafaella Martins Batista1, Yuri Raoni Ramalho Rocha1, Marcelle Alves Borba1