Orbital xanthogranuloma in an adult patient with xanthelasma palpebrarum and hypercholesterolemia.

A 44-year-old man with a history of hypercholesterolemia presented with eyelid lesions and a separate orbital mass. Pathology of eyelid lesions confirmed xanthelasma palpebrarum, and pathology of the orbital mass showed a non-Langerhans cell xanthogranuloma, consistent with a lesion within the spectrum of adult orbital xanthogranulomatous disorders. While xanthelasma palpebrarum is associated with increased serum lipids, adult orbital xanthogranuloma does not share a clear association. Distinct, histology-proven xanthelasma palpebrarum and orbital xanthogranuloma rarely occur together in the literature. This case further represents a unique coexistence between these 2 lesions in an adult with hypercholesterolemia.