Melkersson-Rosenthal syndrome is an uncommon disorder characterized by a triad 
of facial nerve palsy, orofacial edema, and fissured tongue. A 42-year-old woman 
with Melkersson-Rosenthal syndrome presented with painless, nonpitting, 
bilateral asymmetric upper eyelid edema. The left eyelid was a bit larger than 
the right eyelid. CT and MRI demonstrated periorbital soft tissue thickening 
compatible with the microscopic findings of infiltration of lymphocytes, edema, 
and cystic dilatation of lymphatic vessels. After treatment by systemic 
doxycycline and corticosteroid, she showed some improvement of the eyelid edema. 
Isolated bilateral eyelids swelling may be observed in Melkersson-Rosenthal 
syndrome. In the case of unexplained nonpitting eyelid edema, biopsy should be 
performed.