RESUMO
INTRODUCTION: Primary orbitofrontal cholesterol granuloma (OFCG) is rare. We present 4 cases of OFCG and a systematic literature review to examine patient characteristics, presentation, treatment, and outcome. METHODOLOGY: Our institutional records were reviewed for OFCG cases. A systematic literature review was performed using PubMed. Inclusion criteria were English-language studies with pathology-proven OFCG. Exclusion criteria were OFCG in a craniofacial sinus. The search-string yielded 172 results. Fifty studies met inclusion criteria (39 primary and 11 secondary), and relevant data were reviewed. RESULTS: Four patients underwent surgery for OFCG at our institution (ages 53, 43, 34, and 43; 3 females, 1 male). All patients were treated with surgery using a tailored frontal-orbital craniotomy with complete resection. There was no recurrence at 12-month, 4-year, 10-year, and 22-year follow-up for each patient, respectively. Systematic review of the literature identified 172 patients. Follow-up was available in 93 patients (54.1%) with a mean follow-up of 43.3 months. Seven patients demonstrated recurrence at a median of 36 months following surgery. Combining our 4 cases with the 93 patients with reported follow-up gives a recurrence rate of 7% (7/97). Recurrence was associated with incomplete resection and an orbital approach. CONCLUSION: Thorough removal of the lesion with curettage of the boney cavity is recommended for OFCG. Recurrence following complete removal of OFCG is rare.
