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Lyvannak S, Sereyleak B, Khauv P, Mandziuk J, Jarzembowski J, Camitta B. Pyrites: A Conjunctival Mass. J Pediatr Hematol Oncol 2023; 45:e1039-e1040. [PMID: 37027329 DOI: 10.1097/mph.0000000000002665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/22/2023] [Indexed: 04/08/2023]
Affiliation(s)
- Sam Lyvannak
- Angkor Hospital for Children, Siem Reap, Cambodia
| | | | - Phara Khauv
- Angkor Hospital for Children, Siem Reap, Cambodia
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Nüßle S, Glegola M, Schulz T, Lagrèze W, Reinhard T, Auw-Hädrich C. [Conjunctival tumors in children : Histopathological diagnoses in 262 cases]. DIE OPHTHALMOLOGIE 2023; 120:804-810. [PMID: 37493685 DOI: 10.1007/s00347-023-01896-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND The spectrum of conjunctival tumors in children and adolescents significantly differs from that of adults. OBJECTIVE The aim of this study was to show the distribution of histopathological diagnoses of pediatric conjunctival tumors. MATERIAL AND METHODS Retrospective case series including all conjunctival tumors of children and adolescents under 18 years of age examined histologically over a period of 25 years (1990-2015) at the Eye Center in Freiburg, Germany. RESULTS Among the 262 conjunctival specimens, the most common diagnoses were conjunctival nevi (148, [56%]), most often with junctional activity (106/148, [72%]), pyogenic granulomas (26, [10%]), and dermolipomas (18, [7%]). In one case a malignant tumor (conjunctival melanoma) was detected (1, < 1%). CONCLUSION The results suggest that pediatric conjunctival tumors are benign in most cases. Most of them were of melanocytic origin, with a junctional conjunctival nevus being the most common diagnosis.
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Affiliation(s)
- Simone Nüßle
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
- Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland.
| | - Mateusz Glegola
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
- Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Tabea Schulz
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
- Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Wolf Lagrèze
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
- Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Thomas Reinhard
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
- Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Claudia Auw-Hädrich
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
- Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
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Preoperative geometric parameters predict the outcome of lamellar keratoscleroplasty in patients with limbal dermoids. Int Ophthalmol 2023:10.1007/s10792-022-02623-9. [PMID: 36640245 DOI: 10.1007/s10792-022-02623-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE To find preoperative simple geometric parameters to predict the outcome of lamellar keratoscleroplasty in patients with corneal limbal dermoids. METHODS We retrospectively analyzed the data of 30 patients with limbal dermoids who underwent lamellar keratoscleroplasty and were followed up for more than 6 months. Seven geometric parameters were used to analyze the relationship with postoperative visual acuity, astigmatism, and scar formation and investigated for their influence on postoperative outcome. These seven parameters included the cornea-invaded area of dermoid, dermoid area, the cornea-invaded length of dermoid, the corneal limbus invaded length of dermoid, dermoid size, bed size, graft size. Furthermore, we divided patients with corneal limbal dermoids into amblyopia group and non-amblyopia group, and analyzed the clinical characteristics of the amblyopia group. RESULTS The mean age of the patients at surgery was 10.6 ± 5.83 years. The 7 geometric parameters, preoperative and postoperative astigmatism of the amblyopia group were higher than those of the non-amblyopia group (all P < 0.05). Among the geometric parameters analyzed, the r coefficients between the cornea-invaded length of dermoid and postoperative visual acuity and astigmatism were the highest (r = 0.854, r = 0.714). The r coefficient between the corneal limbus invaded length of dermoid and the postoperative scar was the highest (r = 0.375). The r coefficient between age and postoperative steroid-induced high intraocular pressure was the highest (r = - 0.416). In univariate regression analysis, the cornea-invaded length of dermoid was significantly correlated with postoperative visual acuity (β = 0.270, P < 0.001) and postoperative astigmatism (β = 1.362, P < 0.001). Among the geometric parameters analyzed, the cornea-invaded length of dermoid had best stratified patients in grouping with or without amblyopia (cutoff > 2.24). CONCLUSION The cornea-invaded length of dermoid was the most important related factor of postoperative visual acuity, astigmatism, and amblyopia. The corneal limbus invaded length of dermoid was the most important related factor of postoperative scar formation. The geometric parameters and astigmatism in patients with amblyopia were larger than those in patients without amblyopia.
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Cui Y, Yin S, Yin X, Liu Y, Zhao B. Removal of a congenital corneal dermoid through tumor excision and lamellar keratoplasty in a young child: A case report. Medicine (Baltimore) 2021; 100:e27981. [PMID: 34889242 PMCID: PMC8663910 DOI: 10.1097/md.0000000000027981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/11/2021] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Corneal dermoids are a rare cause of corneal opacification, consisting of abnormal mesoblastic tissue surrounded by epithelium. Here, we describe the case of a 1-year-old child who had a congenital corneal dermoid in the left eye since birth; thus, the patient underwent tumor excision followed by keratoplasty. PATIENT CONCERN A 1-year-old girl was brought to the hospital by her parents, who had been noticing a mass on the surface of her left eyeball since birth. The patient had no other previous or concurrent disease nor family history for dermoids. CLINICAL FINDINGS No abnormalities were present in the cornea and the anterior and posterior segments of the right eye. Eye movement, intraocular pressure, and the position of the upper eyelid of the left eye were normal. No signs of conjunctival hyperemia were present. The tumor presented as a yellowish-pink mass with hair and veins on the surface. DIAGNOSE The patient was initially diagnosed with a keratoconjunctival tumor of the left eye by a clinical doctor. INTERVENTIONS Corneal tumor resection combined with keratoplasty was performed in the patient. Eye drops with 1% cyclosporine were administered 3 times per day to prevent immune rejection. OUTCOMES Based on postoperative pathological examinations, the final diagnosis was a corneal dermoid. The patient had an uneventful healing process and rapid corneal re-epithelization. The ocular surface was stable during the follow-up visits, and no complications emerged. LESSONS We report a rare case of congenital corneal dermoid. We learned that close follow-up is needed after surgery in such cases.
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Affiliation(s)
- Yanyan Cui
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shan Yin
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xuewei Yin
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yonghui Liu
- Liaocheng People's Hospital, Liaocheng, China
| | - Bojun Zhao
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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Jakobiec FA, Barrantes PC, Ma L, Mihm M. Epibulbar Proliferative Fasciitis, a Variant of Nodular Fasciitis: A Differential Diagnosis of Conditions With Focal or Diffuse Myxoid Stromas. Ophthalmic Plast Reconstr Surg 2021; 37:399-407. [PMID: 33481533 DOI: 10.1097/iop.0000000000001872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To describe the clinical and pathologic features of a case of epibulbar proliferative fasciitis and to compare it with other focal or diffuse myxoid lesions. METHODS A clinical, histopathologic, and immunohistochemical analysis was performed. The clinical history, photographic documentation, history, and referred slides were reanalyzed. Additional immunohistochemical stains were performed at our institution. RESULTS A 68-year-old woman developed over a week a brightly vascularized and focally hemorrhagic placoid lesion on the temporal side of the OS. She had had earlier augmentation breast surgery that had been mistakenly initially reported to us to be for breast carcinoma. Hematoxylin- and eosin-stained reactions revealed microscopically a spindle cell lesion with an intact nonkeratinizing epithelium and a background myxoid stroma with prominent capillaries and a light dispersion of small T-cell lymphocytes. Most striking among the spindle cells were some widely separated large atypical cells. The atypical cells were cytokeratin positive, but an expansive panel of immunohistochemical stains for breast carcinoma was negative. The lesion was diagnosed as proliferative fasciitis and has not recurred after 1-year follow up. CONCLUSION A rapidly evolving conjunctival lesion is unlikely to be a primary or metastatic carcinoma. In the current case, the large ganglioform or rhabdomyoblast-like cells displayed diffuse cytokeratin positivity, still consistent with a mesenchymal or connective tissue cell lineage. Cytokeratin expression has been a finding previously reported in connective tissue tumors and in lymphoma cells. While the current lesion clinically resembles a conventional nodular fasciitis, the presence of the large atypical cells can lead to the misdiagnosis of a sarcoma, which typically displays a much higher Ki-67 proliferation index in comparison with nodular/proliferative fasciitis.
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Affiliation(s)
- Frederick A Jakobiec
- David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear/Harvard Medical School
| | - Paula Cortes Barrantes
- David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear/Harvard Medical School
| | - Lina Ma
- David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear/Harvard Medical School
| | - Martin Mihm
- Department of Dermatopathology, Brigham and Women's Hospital, Boston, Massachusetts, U.S.A
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Abstract
PURPOSE To search for novel geometric parameters for corneal limbal dermoids that enable the prediction of clinical and surgical outcomes. METHODS We reviewed the medical records and anterior segment photographs of 85 eyes of 85 patients with corneal limbal dermoids that had been surgically excised. Patients were assigned to the following 4 cohorts (multiple assignments allowed): postoperative visual acuity (cohort 1, n = 65), amblyopia (cohort 2, n = 67), postoperative scar formation (cohort 3, n = 51), and preoperative spontaneous progression of dermoids (cohort 4, n = 39). For geometric profiling, 11 geometric parameters of lesions, including orientation, angular width, and 9 ratio parameters, were preoperatively defined in each patient based on the digital anterior-segment photographs. Each geometric parameter and demographic variable were analyzed for correlation with postoperative outcomes (cohorts 1-3) and preoperative spontaneous dermoid progression (cohort 4). RESULTS The mean patient age at surgery was 6.0 ± 6.3 years. Among the geometric and demographic parameters analyzed, the invaded angular axis of dermoid to corneal diameter ratio had the highest r coefficient (r = 0.728) in cohort 1 and best stratified patients in cohort 2 (cutoff > 0.48) and cohort 3 (cutoff > 0.56). No parameters were correlated with spontaneous dermoid progression in cohort 4. CONCLUSIONS We devised geometric parameters to evaluate corneal limbal dermoids before surgery for the prediction of surgical outcomes. The invaded angular axis of dermoid to corneal diameter ratio value was the most significant factor associated with postoperative visual acuity, amblyopia development, and postoperative scarring.
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Shinkre NDN, Usgaonkar UPS. Cavernous Hemangioma of the Conjunctiva. J Ophthalmic Vis Res 2021; 16:303-305. [PMID: 34055269 PMCID: PMC8126747 DOI: 10.18502/jovr.v16i2.9097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 03/25/2020] [Indexed: 11/24/2022] Open
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Lateral canthal choristomas associated with colobomas of lateral canthus. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-020-01701-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Arenas-Canchuja F, Muro-Mansilla P, Urbano Ale E, Silva-Ocas I, Gálvez-Olortegui T, Marroquín-Loayza L. Epibulbar osseous choristoma: A clinical case and review of the literature. ACTA ACUST UNITED AC 2020; 95:289-292. [PMID: 32197870 DOI: 10.1016/j.oftal.2020.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/04/2020] [Accepted: 02/09/2020] [Indexed: 01/24/2023]
Abstract
We present the case of a 3-year-old male child with an epibulbar bone choristoma. The patient presented with a hard consistency subconjunctival mass of 8×10mm in the superior-temporal quadrant of his right eye along with vascularisation and a long cilium of approximately 8 to 10mm that touched the corneal surface. The histopathology study showed the presence of trabeculae of mature, compact bone surrounded by fibrous tissue, as well as Havers channels with concentric rings of laminar bone without bone marrow, and with normal osteocytes which defined the diagnosis of epibulbar bone choristoma. Osseous choristoma is the rarest type of the ocular choristoma and should be considered as a differential diagnosis among paediatric epibulbar tumours.
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Affiliation(s)
- F Arenas-Canchuja
- Instituto Nacional de Oftalmología Dr. Francisco Contreras Campos, Lima, Perú.
| | - P Muro-Mansilla
- Instituto Nacional de Oftalmología Dr. Francisco Contreras Campos, Lima, Perú; Departamento de Atención Especializada en Oculoplástica y Oncología Ocular, Instituto Nacional de Oftalmología Dr. Francisco Contreras Campos, Lima, Perú; Dirección ejecutiva de Investigación y docencia especializada en oftalmología y desarrollo de tecnologías, Instituto Nacional de Oftalmología, Lima, Perú; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - E Urbano Ale
- Instituto Nacional de Oftalmología Dr. Francisco Contreras Campos, Lima, Perú; Laboratorio de Patología Ocular Dr. José Antonio Avendaño Valdez, Instituto Nacional de Oftalmología Dr. Francisco Contreras Campos, Lima, Perú
| | - I Silva-Ocas
- Dirección ejecutiva de Investigación y docencia especializada en oftalmología y desarrollo de tecnologías, Instituto Nacional de Oftalmología, Lima, Perú; Unidad de Investigación Clínica, Scientia Clinical and Epidemiological Research Institute, Trujillo, Perú
| | - T Gálvez-Olortegui
- Departamento de Oftalmología, Hospital Nacional Guillermo Almenara Yrigoyen, Lima, Perú; Unidad de Oftalmología Basada en Evidencias (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Perú
| | - L Marroquín-Loayza
- Instituto Nacional de Oftalmología Dr. Francisco Contreras Campos, Lima, Perú; Laboratorio de Patología Ocular Dr. José Antonio Avendaño Valdez, Instituto Nacional de Oftalmología Dr. Francisco Contreras Campos, Lima, Perú
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García de Oteyza G, García-Albisua AM, Vázquez-Romo KA, Betancourt J, Benedetti Sandner M, Sánchez-Huerta V. Anterior lamellar keratoplasty for the management of a central dermoid tumour in a baby. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2020; 95:48-51. [PMID: 31735598 DOI: 10.1016/j.oftal.2019.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/05/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
A 3-month-old baby presented with a whitish lesion over the right cornea since birth. Due to the clinical and ultrasonic characteristics of the lesion, a manual anterior lamellar keratoplasty was performed. Histopathological examination showed it to be a simple grade II epibulbar choristoma. Although dermoid tumours are usually considered as benign, some of them, depending on their location, can seriously affect the vision of a paediatric patient. Due to the high probability of amblyopia in these cases, a surgical procedure is mandatory. Anterior lamellar keratoplasty is recommended when the visual axis is compromised without intraocular implications.
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Affiliation(s)
- G García de Oteyza
- Servicio de Córnea y Cirugía Refractiva, Asociación Para Evitar la Ceguera en México, Ciudad de México, México; Servicio de Ecografía, Asociación Para Evitar la Ceguera en México, Ciudad de México, México.
| | - A M García-Albisua
- Servicio de Córnea y Cirugía Refractiva, Asociación Para Evitar la Ceguera en México, Ciudad de México, México
| | - K A Vázquez-Romo
- Servicio de Córnea y Cirugía Refractiva, Asociación Para Evitar la Ceguera en México, Ciudad de México, México
| | - J Betancourt
- Servicio de Ecografía, Asociación Para Evitar la Ceguera en México, Ciudad de México, México
| | - M Benedetti Sandner
- Servicio de Córnea y Cirugía Refractiva, Asociación Para Evitar la Ceguera en México, Ciudad de México, México
| | - V Sánchez-Huerta
- Servicio de Córnea y Cirugía Refractiva, Asociación Para Evitar la Ceguera en México, Ciudad de México, México
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Singh M, Kaur M, Grewal AM, Yangzes S, Yadav D, Zadeng Z, Gupta P. Ophthalmic features and management outcomes of 30 children having Goldenhar syndrome. Int Ophthalmol 2019; 40:667-675. [DOI: 10.1007/s10792-019-01227-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 11/14/2019] [Indexed: 01/02/2023]
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Theotoka D, Morkin MI, Galor A, Karp CL. Update on Diagnosis and Management of Conjunctival Papilloma. EYE AND VISION 2019; 6:18. [PMID: 31236424 PMCID: PMC6580461 DOI: 10.1186/s40662-019-0142-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 05/24/2019] [Indexed: 02/08/2023]
Abstract
Conjunctival papilloma is an acquired benign squamous cell tumor that can present at any age, but most frequently in the third and fourth decades of life. Papillomas have been associated with human papilloma virus (HPV) infection, usually types 6 and 11. Although histopathological diagnosis remains the gold standard, the advent of newer non-invasive imaging modalities such as optical coherence tomography (OCT) is transforming the way we diagnose and treat ocular surface tumors, including conjunctival papilloma. Management of these lesions can prove a challenge to the treating physician since not all lesions respond to medical and/or surgical therapy and in fact may worsen after surgical manipulation. In this review, the epidemiology, pathophysiology, clinical characteristics, and diagnosis of conjunctival papilloma including the use of OCT are discussed. Indications, efficacy, and side effects of currently available management options are also reviewed to guide the selection of the best treatment approach.
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Affiliation(s)
- Despoina Theotoka
- 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL 33136 USA
| | - Melina I Morkin
- 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL 33136 USA
| | - Anat Galor
- 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL 33136 USA.,2Miami Veterans Administration Medical Center, 1201 NW 16th Street, Miami, 33125 FL USA
| | - Carol L Karp
- 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL 33136 USA
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Chalkia AK, Bontzos G, Spandidos DA, Detorakis ET. Human papillomavirus infection and ocular surface disease (Review). Int J Oncol 2019; 54:1503-1510. [PMID: 30896784 PMCID: PMC6438422 DOI: 10.3892/ijo.2019.4755] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 03/15/2019] [Indexed: 11/14/2022] Open
Abstract
Human papillomavirus (HPV) infection has been implicated as a primary cause of lesions in the anogenital region, skin, oropharynx and respiratory tract. Additionally, the role of HPV in the pathogenesis of ocular surface disease has also been extensively studied. Conjunctival papilloma development has been strongly associated with the HPV infection of certain subtypes. On the other hand, the role of HPV in conjunctival pterygium, conjunctival intraepithelial neoplasia (CIN) and ocular surface squamous neoplasia (OSSN) remains controversial. Genetic predisposition and environmental factor is important in HPV hosts as regards the pathogenesis of ocular surface disease. Several studies have indicate a synergic role of HPV with ultraviolet radiation in pterygium establishment. A higher recurrence risk rate and more aggressive disease of ophthalmic pterygium is observed in cases of HPV infection. The purpose of this review was to provide a systematic review of the literature and to assist in a better understanding of the role of HPV in ocular surface disease.
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Affiliation(s)
- Aikaterini K Chalkia
- Department of Ophthalmology, University Hospital of Heraklion, 71110 Heraklion, Greece
| | - Georgios Bontzos
- Department of Ophthalmology, Red Cross Hospital, 11526 Athens, Greece
| | - Demetrios A Spandidos
- Department of Virology, Medical School, University of Crete, 71110 Heraklion, Greece
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Villalón ML, Leal MDLÁ, Chávez JR, Santillán EM, Lares-Asseff I, Loera V, Valencia L, Camacho B, Alvarado B, Cervantes V, Patrón L, Almanza H. Recurrent epibulbar dermoid cyst treated with amniotic membrane implant a case report. BMC Surg 2018; 18:98. [PMID: 30428870 PMCID: PMC6236942 DOI: 10.1186/s12893-018-0426-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The dermoid cyst considered a cystic teratoma derived from embryonic germinal epithelium is a slow-growing benign tumour. Dermoid cysts may occur in the orbital and periorbital region in paediatric patients and are often recurrent. The surgical approach depends upon the site of the lesion, superficial or deep. To our knowledge, this is the first described case of a patient with resection of dermoid cyst treated with human amniotic membrane implant and topical application of 0.02% mitomycin C. CASE PRESENTATION We present a case of a 12-year-old male with a tumour in the superotemporal region of the right eye (RE). Symptoms included decreased visual acuity (VA), burning eye, foreign body sensation, and photophobia of the affected eye. A physical examination detected blepharospasm. Ophthalmic examination of his RE, fingers count from a 1-2 m distance, showed no improvement with pinhole. Visual acuity was 20/20 on the left eye (LE). The bio-microscopic examination confirmed the presence of a tumour mass (15 mm × 12 mm) on the surface of the RE, invading the superotemporal sector. The tumour had a lobulated appearance, a shiny and vascularized surface covered by conjunctiva, a pearlescent-pink colour, a medium consistency, was renitent and painless. An ultrasound scan revealed atrophy of the pigmented retinal epithelium with scleral indentation of the RE. A computed tomography (CT) scan revealed a recurrent lesion consistent with an epibulbar dermoid cyst. Surgical excision of the lesion was performed and a human amniotic membrane (HAM) graft and topical 0.02% mitomycin C (MMC) were applied. Histopathological analysis confirmed the diagnosis of recurrent dermoid cyst. CONCLUSION In this case report, we describe a case of recurrent epibulbar dermoid cyst treated with complete resection; topical MMC and HAM implant with good clinical outcome of the lesion and implant adhesion. Resection of a cyst of the ocular surface is not recommended when a large epibulbar dermoid tissue needs to be resected and no HAM graft is available.
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Affiliation(s)
- Ma Luisa Villalón
- The Californias' Children Hospital Ophthalmology Service, Av. Alejandro Von Humboldt 11431, Garita de Otay, 22509, Tijuana, BC, Mexico
| | - Ma De Los Ángeles Leal
- School of Health Sciences, Valle de Las Palmas, Autonomous University of Baja California, Blvd Universitario 1000, Valle de Las Palmas, 22260, Tijuana, BC, Mexico
| | - José R Chávez
- School of Health Sciences, Valle de Las Palmas, Autonomous University of Baja California, Blvd Universitario 1000, Valle de Las Palmas, 22260, Tijuana, BC, Mexico
| | - Eduardo M Santillán
- Fray Junípero Serra Hospital, Security and Social Services Institute for State Workers, Tijuana, Avenida De Las Palmas 1 Col Las Palmas, 22106, Tijuana, BC, Mexico
| | - Ismael Lares-Asseff
- Interdisciplinary Research Center for the Comprehensive Regional Development, Durango Module, Durango, Mexico.,National Polytechnic Institute, Sigma Street #119, Fracc. 20 de Noviembre II, C.P. 34220. Año 2009-2010, Durango Dgo., Mexico
| | - Verónica Loera
- Interdisciplinary Research Center for the Comprehensive Regional Development, Durango Module, Durango, Mexico.,National Polytechnic Institute, Sigma Street #119, Fracc. 20 de Noviembre II, C.P. 34220. Año 2009-2010, Durango Dgo., Mexico
| | - Laura Valencia
- Department of Cellular Biology and Tissue Engineering, Faculty of Medicine and Psychology, Autonomous University of Baja California, Av. Universidad no 14418, Parque Industrial Internacional Tijuana, CP. 22390, Tijuana, BC, Mexico
| | - Blanca Camacho
- Department of Cellular Biology and Tissue Engineering, Faculty of Medicine and Psychology, Autonomous University of Baja California, Av. Universidad no 14418, Parque Industrial Internacional Tijuana, CP. 22390, Tijuana, BC, Mexico
| | - Brenda Alvarado
- Department of Cellular Biology and Tissue Engineering, Faculty of Medicine and Psychology, Autonomous University of Baja California, Av. Universidad no 14418, Parque Industrial Internacional Tijuana, CP. 22390, Tijuana, BC, Mexico
| | - Vilma Cervantes
- Department of Cellular Biology and Tissue Engineering, Faculty of Medicine and Psychology, Autonomous University of Baja California, Av. Universidad no 14418, Parque Industrial Internacional Tijuana, CP. 22390, Tijuana, BC, Mexico
| | - Leslie Patrón
- Department of Cellular Biology and Tissue Engineering, Faculty of Medicine and Psychology, Autonomous University of Baja California, Av. Universidad no 14418, Parque Industrial Internacional Tijuana, CP. 22390, Tijuana, BC, Mexico
| | - Horacio Almanza
- Department of Cellular Biology and Tissue Engineering, Faculty of Medicine and Psychology, Autonomous University of Baja California, Av. Universidad no 14418, Parque Industrial Internacional Tijuana, CP. 22390, Tijuana, BC, Mexico.
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Pennington JD, Welch RJ, Lally SE, Shields JA, Eagle RC, Shields CL. Botryoid Rhabdomyosarcoma of the Conjunctiva in a Young Boy. Middle East Afr J Ophthalmol 2018; 25:111-114. [PMID: 30122858 PMCID: PMC6071337 DOI: 10.4103/meajo.meajo_8_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Primary conjunctival rhabdomyosarcoma (RMS) is a rare entity that can present with or without papillomatous features. A 5-year-old Asian boy was referred for a rapidly growing conjunctival tumor in the superior fornix of the left eye. Surgical excision yielded a 28 mm multilobulated papillomatous specimen that exhibited histopathologic and immunohistochemical features consistent with embryonal (botryoid) RMS. Molecular analysis revealed the absence of the PAX3/FOXO1 fusion gene, indicating favorable prognosis. After surgery, he was promptly treated with systemic chemotherapy and proton beam radiotherapy.
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Affiliation(s)
- Justin D Pennington
- Department of Pathology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - R Joel Welch
- Department of Pathology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Sara E Lally
- Department of Pathology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Jerry A Shields
- Department of Pathology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Ralph C Eagle
- Department of Pathology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Carol L Shields
- Department of Pathology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Abstract
Purpose: To establish a new scoring system for limbal dermoid, in order to unify the diagnostic criteria and assess the prognosis. Methods: A retrospective study was conducted on 261 patients with limbal dermoid. The basic information, clinical features, and pathology of dermoids were recorded, and the prognosis at 1 year after keratoplasty was assessed at follow-up. A new visual scoring system was created for the area of corneal involvement, the area of conjunctival involvement, and the surface shape. Results: There were 154 females and 107 males with mean age of 4 ± 3 years at surgery. After scoring, 59% (136) of patients were classified as grade I, 26% (60) as grade II, and 14% (33) as grade III. The pathological results were 124 dermoid cases, 76 lipodermoid, 5 complex choristoma, and 10 epibulbar osseous choristoma. Moreover, patients with lower clinical scores presented a better prognosis; the mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity in grade I patients was 0.38 ± 0.05, which was better than the grade II value of 0.61 ± 0.09 (P < 0.05) and the grade III value of 0.94 ± 0.11 (P < 0.001). Conclusions: New grading systems for limbal dermoid were useful for clinical diagnosis and may have prognostic value in predicting visual acuity. A lower-grade dermoid exhibited better vision postoperatively.
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18
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Ojha PR, Deshpande AH, Gargade CB, Nigam JS. Epipalpebral conjunctival chondroid choristoma: Interesting developmental anomaly presenting in an adult. Indian J Ophthalmol 2017; 65:613-614. [PMID: 28724821 PMCID: PMC5549416 DOI: 10.4103/ijo.ijo_39_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ocular choristomas are uncommon lesions chiefly presenting in children. Choristomas may contain dermal and epidermal components, muscle, cartilage, bone, etc. They are usually seen in epibulbar conjunctiva, but epipalpebral location is uncommon. We present a case of epipalpebral chondroid choristoma presenting in an adult patient.
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Affiliation(s)
- Pushpanjali R Ojha
- Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands, India
| | - Archana Hemant Deshpande
- Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands, India
| | - Chitrawati Bal Gargade
- Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands, India
| | - Jitendra Singh Nigam
- Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands, India
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19
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Abstract
We present a case of a 15-year-old girl with an epibulbar osseous choristoma. The patient presented with a 3×3 mm, whitish, firm subconjunctival mass in the superotemporal quadrant of her right eye with vascularization. She underwent excision biopsy of the mass under topical anesthesia. The pathologic sections were consistent with a well-circumscribed osseous tissue without atypia. Osseous choristoma is one of the rare types of ocular choristoma to be considered in the differential diagnosis of pediatric epibulbar tumors.
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Affiliation(s)
- Thendral Ponnudurai
- Cornea Department, Institute of Ophthalmology, Joseph Eye Hospital, Trichy, Tamilnadu, India
| | - Sophia Louisraj
- Cornea Department, Institute of Ophthalmology, Joseph Eye Hospital, Trichy, Tamilnadu, India
| | - Amjad Salman
- Cornea Department, Institute of Ophthalmology, Joseph Eye Hospital, Trichy, Tamilnadu, India
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20
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Abstract
Conjunctival biopsies constitute a fairly large number of cases in a typical busy ophthalmic pathology practice. They range from a single biopsy through multiple mapping biopsies to assess the extent of a particular pathological process. Like most anatomical sites, the conjunctiva is subject to a very wide range of pathological processes. This article will cover key, commonly encountered nonneoplastic and neoplastic entities. Where relevant, sections will include recommendations on how best to submit specimens to the ophthalmic pathology laboratory and the relevance of up-to-date molecular techniques.
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21
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The association of maternal factors with epibulbar dermoid of newborn: a retrospective, matched case-control study. Eye (Lond) 2017; 31:1099-1105. [PMID: 28338666 DOI: 10.1038/eye.2017.40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 01/31/2017] [Indexed: 12/16/2022] Open
Abstract
PurposeTo determine the association of maternal factors and exposure during pregnancy with the incidence in newborns of epibulbar dermoid (ED), a congenital ocular surface benign tumor.Patients and methodsThis is a retrospective, paired case-control study in which 121 children with ED (case group) and 121 children without ED (control group) were recruited. Questionnaire-based interviews with mothers of participants were performed and maternal medical records during pregnancy were reviewed. The questionnaire investigated basic information, personal history, environmental exposure, exposure to maternal diseases, symptoms and corresponding medical treatments during pregnancy, and parental socioeconomic status. The case and control participants were matched for sex, birth weight, gestational age, and parental socioeconomic status level. Univariate and multivariate logistic regression analyses were conducted with ED as the main outcome variable.ResultsFactors significantly associated with ED were: history of maternal inevitable miscarriage (odds ratio (OR), 2.59; 95% confidence intervals (CI), 1.13-5.90), common cold in the first trimester (OR, 3.94; CI, 1.74-8.93), and paternal smoke exposure >half a pack per day during pregnancy (OR, 4.81; CI, 1.74-13.28).ConclusionHistory of maternal miscarriage, common cold exposure in the first trimester, and paternal smoking (>half a pack per day) during pregnancy could result in significant risk factors for ED of newborns. These data also imply that paternal smoking delivers nicotine to maternal respiratory system and uterine microenvironment that may both affect microvascular development and predispose the fetus to future ED.
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22
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Kim JH, Ahn YJ, Whang WJ, Park SH. Astigmatic Analysis before and after Surgical Excision of Limbal Dermoid: Functional Outcome. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.9.1092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ji Hyun Kim
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ye Jin Ahn
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woong Joo Whang
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Shin Hae Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Harkins KA, Perry D, Suh DW. Epibulbar osseous choristoma: A case report. Am J Ophthalmol Case Rep 2016; 5:4-6. [PMID: 29503936 PMCID: PMC5757779 DOI: 10.1016/j.ajoc.2016.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 09/22/2016] [Accepted: 10/07/2016] [Indexed: 11/29/2022] Open
Abstract
Purpose To present the case of a 12-year-old female with an epibulbar osseous choristoma. Observations The patient presented with right-sided conjunctival mass, which caused her discomfort. Slit lamp examination revealed a 5×5-mm, firm nodule in the superotemporal quadrant of the bulbar conjunctiva. The nodule had feeder vessels, adhered firmly to the sclera, and lacked signs of malignancy. The patient underwent excisional biopsy under general anesthesia. During this procedure, great care was taken to avoid perforation of the globe. The pathologic sections were significant for well-circumscribed osseous tissue without atypia. Conclusions and importance We describe diagnosis and successful surgical management of osseous choristoma the rarest subtype of ocular choristoma. With only 65 cases reported since mid-19th century, the condition remains poorly described. This report provides additional information on diagnosis and treatment of this rare condition.
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Affiliation(s)
- Keegan A Harkins
- Stanley M Truhlsen Eye Institute, Department of Ophthalmology and Visual Science, University of Nebraska Medical Center, Omaha, NE, USA
| | - Deborah Perry
- Children's Hospital and Medical Center, Omaha, NE, USA
| | - Donny W Suh
- Stanley M Truhlsen Eye Institute, Department of Ophthalmology and Visual Science, University of Nebraska Medical Center, Omaha, NE, USA.,Children's Hospital and Medical Center, Omaha, NE, USA
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Walker BA, Saltzman BS, Herlihy EP, Luquetti DV. Phenotypic characterization of epibulbar dermoids. Int Ophthalmol 2016; 37:499-505. [PMID: 27405313 DOI: 10.1007/s10792-016-0285-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 07/02/2016] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to characterize the phenotypic presentation, clinical course, and outcomes of epibulbar dermoids (EpDs) which are the most common congenital eye tumor in children. Sixty-eight dermoids were identified in 58 eyes of 48 patients of Seattle Children's Hospital between 1981 and 2014 via electronic medical record search. Patients were organized into: "EpD-Only" [patients without other congenital anomalies (n = 13)], "EpD-CFM" [patients with a craniofacial microsomia (CFM) diagnosis (n = 25)], and "EpD-Other" [patients with other congenital anomalies (n = 10)]. All EpD in the EpD-Only group were unilateral and singular, while the EpD-CFM group had six cases with multiple unilateral EpD and five cases with bilateral EpD. In the EpD-Only group, 69 % of EpD were left sided, whereas in the EpD-CFM group, there was no side predisposition. Among both groups, the majority of EpD were limbal or lipodermoids in the inferotemporal quadrant of the eye. Surgery was more common and at a younger age in the EpD-CFM group than the EpD-Only group (56 vs. 38 %, 5.2 vs. 7.0 years). Follow-up surgeries occurred only in the EpD-CFM group (21 %). EpDs were most commonly associated with preauricular tags, congenital heart defects, genitourinary, and nervous system anomalies. Whereas the location and type of EpDs did not significantly differ between the groups, the phenotype in the EpD-Only group appears to be less complex. This may indicate an important difference between EpDs in isolation and those within CFM. Additional studies will further characterize these phenotypes and outcomes.
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Affiliation(s)
- Brian A Walker
- University of Washington School of Medicine, Seattle, WA, USA.
- Seattle Children's Research Institute, Seattle, WA, USA.
| | - Babette S Saltzman
- Seattle Children's Research Institute, Seattle, WA, USA
- Craniofacial Center, Seattle Children's Hospital, Seattle, WA, USA
| | - Erin P Herlihy
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- Department of Surgery, Division of Pediatric Ophthalmology, Seattle Children's Hospital, Seattle, WA, USA
| | - Daniela V Luquetti
- Seattle Children's Research Institute, Seattle, WA, USA
- Craniofacial Center, Seattle Children's Hospital, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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25
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Abstract
PURPOSE To describe the clinical and histopathologic features distinguishing an extensive complex choristoma of the epibulbar surface and to address the management of such lesions. METHODS Clinical history, diagnostic imaging studies, and histopathologic sections stained with hematoxylin and eosin were reviewed from a 2-year-old girl with a congenital conjunctival lesion of the right eye that was surgically excised. RESULTS The patient clinically displayed an extensive, vascularized amelanotic conjunctival lesion located superotemporally with extension onto the cornea. Her visual acuity was reduced to 20/670. The clinical diagnosis was a large lacrimal gland choristoma with corneal involvement and resulting deprivation amblyopia. The patient underwent an excision of the lesion including the corneal portion, and the ocular surface was reconstructed with amniotic membrane. Histopathologic evaluation disclosed lobules of lacrimal tissue and cartilage plaques, smooth muscle, and nerves consistent with a complex choristoma. Six weeks postoperatively, the visual acuity had improved to 20/180. The patient returned to her local ophthalmologist for amblyopia management. CONCLUSIONS We emphasize the importance of recognizing lesion-induced amblyopia and the timely performance of appropriate surgery for complex epibulbar choristomas. A differential diagnosis of other congenital epibulbar lesions is provided.
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Avgitidou G, Koch KR, Fries JWU, Cursiefen C, Heindl LM. [Pediatric conjunctival tumor with cilia]. Ophthalmologe 2016; 113:783-5. [PMID: 26879556 DOI: 10.1007/s00347-016-0222-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- G Avgitidou
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland.
| | - K R Koch
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - J W U Fries
- Institut für Pathologie, Universität zu Köln, Köln, Deutschland
| | - C Cursiefen
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - L M Heindl
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
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27
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Aliakbar-Navahi R, Ashraf MJ, Seirfar N, Koohestani S, Abedi E. Conjunctival Lesions; a Histopathologic Review in Fars Province, Iran. J Ophthalmic Vis Res 2015; 10:98-101. [PMID: 26425308 PMCID: PMC4568625 DOI: 10.4103/2008-322x.163774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: To determine the prevalence of various types of conjunctival lesions, at a tertiary ophthalmic center in Fars Province, South of Iran. Methods: Histopathologic slides and medical records of conjunctival lesions submitted to the pathology department of Khalili Hospital, Shiraz, Iran were reviewed from April, 2009 to July, 2013. The histopathologic diagnoses were categorized into benign, pre-malignant, and malignant lesions. The prevalence of various types of conjunctival lesions was calculated. Results: Histologic sections of 631 conjunctival lesions were reviewed. Benign lesions were most prevalent (81.8%), followed by premalignant (10.8%) and malignant (7.4%) lesions. Pterygia were the most common benign lesions (69.2%), intraepithelial dysplasia constituted most cases of premalignant lesions (94.1%), and squamous cell carcinoma was the most frequent malignant lesion (93.6%). Benign lesions were the most common type of lesions in all age groups, however the prevalence of malignant lesions increased significantly with age (P < 0.001). Conclusion: Benign lesions were the most common conjunctival lesions with pterygia on top of the list, while intraepithelial neoplasia and squamous cell carcinoma were the most common premalignant and malignant lesions, respectively. Conjunctival malignant lesions were more prevalent with older age.
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Affiliation(s)
- Roshanak Aliakbar-Navahi
- Department of Ophthalmology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Javad Ashraf
- Department of Pathology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nosaibe Seirfar
- Department of Pathology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samaneh Koohestani
- Department of Ophthalmology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Abedi
- Department of Pathology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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28
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Inverted mucoepidermoid papilloma of conjunctiva in a child. J AAPOS 2015; 19:266-7. [PMID: 25818286 DOI: 10.1016/j.jaapos.2014.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 12/03/2014] [Accepted: 12/07/2014] [Indexed: 12/28/2022]
Abstract
Inverted papillomas are benign epithelial tumors usually arising from the mucous membrane of the sinonasal cavity and the urinary tract. Similar tumors of the conjunctiva are much rarer. We describe a case of juxtalimbal inverted papilloma in an 11-year-old boy who presented with a pigmented lesion that simulated a conjunctival nevus. Excisional biopsy established the diagnosis of inverted papilloma. The patient was carefully followed for 2 years, because the tumor's behavior in the conjunctiva is unknown. There was no recurrence of the lesion.
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Abstract
The topic of this case report is a rare subconjuctival osseous choristoma that corresponded to the left lateral sunconjunctiva and canthus. A 20-year-old man was asymptomatic when he arrived for the examination. His full ophthalmic examination was normal. Orbital computerized tomography was concordant with osseous lesion. Osseous choristomas are the rarest forms of ocular choristomas, they are usually being defined as sporadic, and they are found at the superior temporal region of the episclera. In our case, choristoma was in the lateral canthus of the left eye. We had administered surgical excision by reason of the patient's cosmetic requirement. We had noted that the lesion was adherent to conjunctiva but not to the sclera and the muscles. After surgical treatment, we saw mature heterotrophic osseous tissue in subconjunctival area and Haversian canals in compact bone tissue.
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31
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Abstract
Epidermal nevus syndrome (ENS) is an inclusive term for a heterogeneous group of congenital disorders characterized by the presence of epidermal nevi associated with systemic involvement. These disorders, as are all primary neurocutaneous syndromes, are neurocristopathies. The epidermal nevi that follow the lines of Blaschko and most systemic anomalies in skeletal, ocular, cardiovascular, endocrine, and orodental tissues, as well as lipomas, are due to defective neural crest. The most important and frequent anomaly in the brain in all forms of epidermal nevus syndromes (ENSs) is hemimegalencephaly (HME). This malformation often is not recognized, despite being the principal cause of neurological manifestations in ENSs. They consist mainly of epilepsy and developmental delay or intellectual disability. The onset of epilepsy in ENS usually is in early infancy, often as infantile spasms. Several syndromic forms have been delineated. I propose the term "Heide's syndrome" for those distinctive cases with the typical triad of hemifacial epidermal nevus, ipsilateral facial lipoma, and hemimegalencephaly. Most ENSs are sporadic. The mechanism is thought to be genetic mosaicism with a lethal autosomal dominant gene. Specific genetic mutations (PTEN, FGFR3, PIK3CA, and AKT1) have been documented in some patients. The large number of contributors for over more than a century and a half to the description of these disorders precludes the use of new author eponyms.
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Affiliation(s)
- Flores-Sarnat Laura
- Departments of Clinical Neurosciences and Paediatrics, Division of Paediatric Neurology, University of Calgary, Alberta Children's Hospital, Calgary, Canada.
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Complex choristoma of the lacrimal caruncle: a case report of an unusual congenital tumor with clinical and histopathological classification. Int Ophthalmol 2012; 32:37-9. [PMID: 22213061 DOI: 10.1007/s10792-011-9506-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Accepted: 12/20/2011] [Indexed: 10/14/2022]
Abstract
Rare congenital tumors can be localized in the peribulbar area. Here we report an unusual case presented in a 3-year-old child with a history of a congenital tumor in the lacrimal caruncle of the right eye, associated with epiphora and constant discomfort. A surgical resection was performed, and the final histopathological diagnosis was lacrimal caruncle complex choristoma. Choristomas are growths of apparently normal tissue in an abnormal location, which can be situated anywhere in the body, including ocular and peribulbar structures. These almost unknown congenital tumors constitute the most common conjunctival tumors in children and can be interpreted clinically as different lesions, which are only differentiated through precise histopathological analysis.
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Solitary neurofibroma without neurofibromatosis in the superior tarsal plate simulating a chalazion. Graefes Arch Clin Exp Ophthalmol 2011; 250:309-10. [DOI: 10.1007/s00417-010-1593-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 12/01/2010] [Accepted: 12/02/2010] [Indexed: 10/18/2022] Open
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35
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Warner MA, Bhat PV, Jakobiec FA. Subepithelial Neoplasms of the Conjunctiva. Cornea 2011. [DOI: 10.1016/b978-0-323-06387-6.00048-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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36
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Jakobiec FA, Pineda R, Rivera R, Hsu-Winges C, Cherwek D. Epicorneal polypoidal lipodermoid: lack of association of central corneal lesions with goldenhar syndrome verified with a review of the literature. Surv Ophthalmol 2010; 55:78-84. [PMID: 19783022 DOI: 10.1016/j.survophthal.2009.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Accepted: 05/01/2009] [Indexed: 11/24/2022]
Abstract
It is remarkable to uncover a new aspect of congenital epibulbar solid dermoids and lipodermoids. We describe a dramatic central epicorneal polypoidal lipodermoid coloboma accompanied by an upper eyelid coloboma that was not associated with Goldenhar syndrome. Histopathologically the excised lesion displayed superficial layers of epidermis and a thin dermis with eccrine glands, vestigial hair structures, and bundles of arrector pili smooth muscle that extended from the undersurface of the epidermis to the bulge area of the primitive hairs. This last feature is not present in normal eyelid skin nor in the conjunctiva, and has not been previously documented to occur in epibulbar dermoids and lipodermoids. S-100-positive dendritic melanocytes and CD1a-positive Langerhans cells were both observed intraepidermally, indicating a complete complement of normal cells in this layer. Beneath the dermis was a massive collection of lobules of mature adipose tissue that fused with the corneal stroma. A virtually identical pedunculated limbal tumor has been previously reported that was associated with Goldenhar syndrome. Review of earlier published cases of epibulbar dermoids and lipodermoids establishes that central corneal lesions are not a stigma of Goldenhar syndrome, in contrast to limbal masses. Other epibulbar choristomas that can be confused with lipodermoids are described.
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Affiliation(s)
- Frederick A Jakobiec
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
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37
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Solid Corneal Dermoids and Subconjunctival Lipodermoids: Impact of Differentiated Surgical Therapy on the Functional Long-Term Outcome. Cornea 2009; 28:644-51. [DOI: 10.1097/ico.0b013e3181914305] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Paire V, Bossard C, Vabres B, Weber M, Péchereau A. Localisations orbitaires de la maladie de Rosai-Dorfman : série de trois cas consécutifs. J Fr Ophtalmol 2008; 31:673-82. [DOI: 10.1016/s0181-5512(08)74381-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
PURPOSE OF REVIEW Numerous conjunctival tumors can occur in children, originating from tissues of choristomatous, epithelial, melanocytic, vascular, fibrous, xanthomatous and lymphoid. Overall, 97% prove to be benign and only 3% are malignant. RECENT FINDINGS The most common malignancies include conjunctival lymphoma and melanoma. In our experience, the most common conjunctival tumors in children include nevus (64%), dermolipoma (5%), lymphangioma (3%) and capillary hemangioma (3%). Conjunctival nevi can manifest as a darkly pigmented (65%), lightly pigmented (19%) and completely nonpigmented (16%) mass. Most nevi occurred at the nasal or temporal limbus, without involvement of the cornea. Occasionally, they are located in the caruncle, but rarely are nevi found in the fornix or tarsal conjunctival surface. Intralesional cysts are visible in 65% of nevi. Change in nevus color over time has been noted in 5% of cases and change in nevus size has been documented in 7%. Evolution of conjunctival nevus into malignant melanoma is extremely low (<1%). SUMMARY Conjunctival nevus is the most common conjunctival tumor in children and fewer than 1% evolve into melanoma over time.
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Affiliation(s)
- Carol L Shields
- Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
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40
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Abstract
A nodular, epibulbar mass appearing in an adult woman without antecedent inflammation or injury prompted concern for possible malignancy. Excision was performed, and pathologic examination demonstrated a conjunctival fibroma. The rarity of the fibroma and its clinical similarity to other benign or malignant tumors render its clinical diagnosis elusive.
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Affiliation(s)
- Norman C Charles
- Department of Ophthalmology, New York University Medical Center, New York, New York 10016, USA.
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41
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Kim BJ, Kazim M. Bilateral symmetrical epibulbar osseous choristoma. Ophthalmology 2006; 113:456-8. [PMID: 16513460 DOI: 10.1016/j.ophtha.2005.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2004] [Accepted: 03/15/2005] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To report a patient with bilateral symmetrical epibulbar osseous choristoma. DESIGN Retrospective observational case report. PARTICIPANT One patient with bilateral symmetrical epibulbar osseous choristoma. METHOD Retrospective review of stored office records, photographs, computed tomography (CT), and histopathological findings. MAIN OUTCOME MEASURES Appearance of the choristoma, CT, and histopathological findings. RESULTS A 6-year-old female had bilateral superotemporal subconjunctival masses. Surgical excision was performed bilaterally. The lesions were encapsulated and attached to the sclera, and consisted histopathologically of epibulbar osseous choristoma. CONCLUSION We report the first case of bilateral symmetrical epibulbar osseous choristoma without other associated choristomas. Preoperative CT imaging is helpful in assessing the extent of the tumor and planning surgery.
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Affiliation(s)
- Byoung Jin Kim
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
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Grüb M, Reinthal E, Rohrbach JM. [Congenital tumor of the temporal eyelid]. Ophthalmologe 2005; 103:56-8. [PMID: 15706456 DOI: 10.1007/s00347-004-1169-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- M Grüb
- Abteilung I: Erkrankungen des vorderen und hinteren Augenabschnittes, Universitätsaugenklinik, Tübingen.
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Shields CL, Demirci H, Karatza E, Shields JA. Clinical survey of 1643 melanocytic and nonmelanocytic conjunctival tumors. Ophthalmology 2004; 111:1747-54. [PMID: 15350332 DOI: 10.1016/j.ophtha.2004.02.013] [Citation(s) in RCA: 223] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2003] [Accepted: 02/29/2004] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To report the spectrum and frequency of melanocytic and nonmelanocytic conjunctival tumors in an ocular oncology practice. DESIGN Retrospective noninterventional case series. PARTICIPANTS One thousand six hundred forty-three consecutive patients with a conjunctival mass evaluated at an ocular oncology department. METHODS A chart review was conducted to obtain the clinical features of the patient and tumor and to tabulate and categorize the diagnoses. MAIN OUTCOME MEASURES Tumor diagnosis overall and relative to patient age, race, and gender and relative to tumor location and laterality. RESULTS In 1643 consecutive patients, the tumor was classified as melanocytic in 872 cases (53%) and nonmelanocytic in 771 cases (47%). The nonmelanocytic categories included congenital choristomatous (n = 40 [2%]), epithelial (n = 219 [13%]), vascular (n = 63 [4%]), fibrous (n = 7 [<1%]), neural (n = 1 [<1%]), xanthomatous (n = 1 [<1%]), myxomatous (n = 1 [<1%]), lipomatous (n = 23 [1%]), lacrimal gland origin (n = 12 [<1%]), lymphoid (n = 128 [8%]), leukemic (n = 3 [<1%]), metastatic (n = 13 [<1%]), secondary (n = 54 [3%]) tumors, and non-neoplastic lesions simulating a tumor (n = 206 [13%]). Of the 872 melanocytic lesions, the specific tumor diagnosis was nevus in 454 cases (52%), melanoma in 215 (25%), and primary acquired melanosis in 180 (21%). Patients with choristomatous, vascular, fibrous, xanthomatous, and myxomatous tumors presented at a mean age of <40 years, and those with malignant epithelial, lipomatous, leukemic, and secondary tumors presented at a mean age of >60. Of the 219 patients with epithelial tumors, 80% occurred in males, whereas the incidence of melanocytic lesions was equal in males and females. African-American patients represented only 7% of epithelial tumors, <1% of melanomas, and 8% of lymphoid tumors. CONCLUSION Conjunctival tumors were of melanocytic origin in 53% of cases and nonmelanocytic origin in 47%. Overall, melanocytic tumors, epithelial tumors, and lymphoid tumors accounted for 74% of all cases. These tumors were far more common in Caucasian patients, and epithelial tumors were found more frequently in men.
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Affiliation(s)
- Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA
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Abstract
Most ocular and orbital tumors of childhood are distinct from tumors that occur in adults. Many are congenital with early presentations. Most pediatric orbital tumors are benign; developmental cysts comprise half of orbital cases, with capillary hemangioma being the second most common orbital tumor. The most common orbital malignancy is rhabdomyosarcoma. The most common intraocular malignant lesion is retinoblastoma. Choroidal melanoma, which is common in adults, is extremely rare in children. The orbit is the most common location for metastases in children, whereas the choroid is the predominant site in adults. Pediatricians play a vital role in diagnosis of pediatric ocular tumors. They are the first to recognize ocular problems that may not be apparent to parents. It is therefore important to recognize the signs and symptoms of ocular tumors of childhood so that prompt ophthalmologic evaluation and treatment may be undertaken. Whereas the malignant tumors may be life-threatening, both malignant and benign tumors may be vision-threatening.
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Affiliation(s)
- Bienvenido V Castillo
- Division of Pediatric Ophthalmology and Strabismus, Loyola University Medical Center, 2160 First Avenue, Maywood, IL 60152, USA
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Marback EF, Stout TJ, Rao NA. Osseous choristoma of the conjunctiva simulating extraocular extension of retinoblastoma. Am J Ophthalmol 2002; 133:825-7. [PMID: 12036677 DOI: 10.1016/s0002-9394(02)01351-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE To report the clinicopathologic features of an epibulbar osseous choristoma simulating extraocular extension of retinoblastoma. DESIGN Interventional case report. METHODS A 7-month-old male presented with a unilateral intraocular mass localized to the temporal retina and a white pedunculated lesion extending from the conjunctiva, anterior to the insertion of the lateral rectus muscle. Clinical examination and computed tomography scan findings led to the diagnosis of retinoblastoma with extraocular extension. The child underwent excision of the epibulbar lesion and enucleation of the globe. RESULTS The histopathologic examination of the epibulbar lesion revealed an osseous choristoma. The intraocular contents displayed features typical of retinoblastoma without extraocular extension. CONCLUSION An epibulbar osseous choristoma can simulate extraocular extension of retinoblastoma in an eye harboring the intraocular malignancy.
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Affiliation(s)
- Eduardo F Marback
- Doheny Eye Institute and the Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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Abstract
PURPOSE To evaluate results of lamellar keratoplasty in limbal dermoid. METHODS The ocular records were reviewed of 155 consecutive eyes with solid epibulbar dermoids that underwent lamellar keratoplasty at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences from 1977 to 1998. According to the size and location, the dermoids were managed surgically either by sectoral, annular, or central lamellar keratoplasty. RESULTS All but 16 eyes improved cosmetically; while all the patients showed reduction in astigmatism, 116 eyes improved functionally. CONCLUSION Excision with lamellar keratoplasty appears to be an effective means of management for extensive limbal dermoid. To avoid development of amblyopia, surgery at an early age is preferred.
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Affiliation(s)
- Anita Panda
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi
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Sjö NC, Heegaard S, Prause JU, von Buchwald C, Lindeberg H. Human papillomavirus in conjunctival papilloma. Br J Ophthalmol 2001; 85:785-7. [PMID: 11423448 PMCID: PMC1724043 DOI: 10.1136/bjo.85.7.785] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIM To examine conjunctival papillomas for the presence of human papillomavirus (HPV) and koilocytosis. METHODS Archival paraffin embedded tissue from 55 conjunctival papillomas was analysed for the presence of HPV by polymerase chain reaction and subsequent filter hybridisation. Histological sections of the 55 papillomas were evaluated for the presence of koilocytosis. RESULTS HPV was present in 48 of 52 (92%) beta globin positive papillomas. HPV type 6/11 were found in 40 of 47 investigated papillomas and a double infection with HPV 6/11 and 16 was identified in a single papilloma. In six papillomas the HPV type could not be identified. Koilocytosis was present in 22 of 55 papillomas (40%). CONCLUSION There is a strong association between HPV and conjunctival papillomas. HPV type 6/11 is the most common HPV type in conjunctival papilloma. The sensitivity of koilocytosis as an indicator of HPV in conjunctival papilloma is low.
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Affiliation(s)
- N C Sjö
- Eye Pathology Institute, University of Copenhagen, Denmark
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Singal A, Dhaliwal U, Bhattacharya SN, Rohatgi J, Singh N. Complex ocular choristomas in linear nevus sebaceus syndrome: a report of two cases. J Dermatol 2001; 28:259-64. [PMID: 11436364 DOI: 10.1111/j.1346-8138.2001.tb00129.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Two cases of linear nevus sebaceus syndrome (LNSS) are described in which ipsilateral facial nevus of Jadassohn was associated with complex ocular choristoma. One patient also had scleral osteomas, a rare occurrence in LNSS.
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Affiliation(s)
- A Singal
- Department of Dermatology, University College of Medical Sciences and GTB Hospital, Delhi, India
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Feinberg AS, Spraul CW, Holden JT, Grossniklaus HE. Conjunctival lymphocytic infiltrates associated with Epstein-Barr virus. Ophthalmology 2000; 107:159-63. [PMID: 10647735 DOI: 10.1016/s0161-6420(99)00014-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To describe the clinicopathologic features of two patients with Epstein-Barr virus (EBV) associated conjunctival lymphocytic infiltrates. DESIGN Two case reports. METHODS The clinical histories and pathologic findings of two patients with salmon-colored conjunctival infiltrates are described. MAIN OUTCOME MEASUREMENTS Clinical observation and pathologic examination of conjunctival biopsy specimens with accompanying immunohistochemical staining, flow cytometric immunophenotyping, and polymerase chain reaction analysis when appropriate. RESULTS One patient had ipsilateral preauricular lymphadenopathy, elevated serum EBV titers, and a unilateral reactive lymphocytic infiltrate resulting in a conjunctival mass. The other patient had bilateral conjunctival lymphocytic infiltrates causing conjunctival masses. There was an expanded clonal population of B lymphocytes in the conjunctival mass in the second patient. Both patients had EBV antigen in their conjunctival lymphocytic infiltrates. CONCLUSIONS Conjunctival lymphocytic lesions associated with EBV represent a spectrum of reactive infiltrates to monoclonal populations.
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Affiliation(s)
- A S Feinberg
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA
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