1
|
Pandya M, Thool AR, Daigavane S. Linear Nevus Sebaceous Syndrome: Clinical Presentation and Management Considerations. Cureus 2024; 16:e60487. [PMID: 38883086 PMCID: PMC11180521 DOI: 10.7759/cureus.60487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
A relatively rare neurocutaneous condition known as linear nevus sebaceous syndrome (LNSS) is marked by a variety of symptoms as well as the unusual characteristics of developing mosaic RASopathies of phacomatoses. Mental retardation, seizures, and midline facial linear nevus sebaceous were the usual diagnostic triad. A hallmark of LNSS is the papillomatous growth of the epidermis, also known as nevus sebaceous. In this case report, we presented a case of a 13-year-old male with LNSS with a vascular conjunctival lesion and a coloboma of the optic disc.
Collapse
Affiliation(s)
- Meghavi Pandya
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Archana R Thool
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sachin Daigavane
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Yan Y, Zhang S, Zhou H, Zhou Y, Fu Y. Ophthalmic Manifestation and Pathological Features in a Cohort of Patients With Linear Nevus Sebaceous Syndrome and Encephalocraniocutaneous Lipomatosis. Front Pediatr 2021; 9:678296. [PMID: 34095036 PMCID: PMC8177968 DOI: 10.3389/fped.2021.678296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose: This study aimed to figure out the association between ophthalmic and pathological features in patients with Linear Nevus Sebaceous Syndrome (LNSS) and in patients with Oculoectodermal Syndrome-Encephalocraniocutaneous Lipomatosis (OES-ECCL). Methods: It is a retrospective, non-consecutive, observational case series. Twenty-seven patients (12 with LNSS and 15 with OES-ECCL, 41 eyes) referred to the Department of Ophthalmology of the Shanghai Ninth People's Hospital between 2000 and 2020 were included. The mean age of the study population for the first-time consult was 5.7 years, ranging from 3 months to 34 years. Clinical notes, pathological records, and imaging findings were reviewed in all the patients. Results: Fourteen (51.9%) cases showed bilateral ocular involvement. Epibulbar choristomas were seen in all the patients. All the lesions involved the conjunctiva and cornea simultaneously. Multiple lesions were observed in 12 eyes. Of the 14 excised lesions, 11 were found to be complex choristomas. Further, 24 (89%) patients had eyelid coloboma. Also, 13 patients (48%) were diagnosed with strabismus, and 12 patients (44%) had abnormal fundus imaging, including optic nerve hypoplasia. Conclusions: LNSS and OES-ECCL shared common ophthalmic features, including epibulbar choristomas with distinctive characteristics, eyelid coloboma, strabismus, and optic nerve hypoplasia. The complex choristoma was found to be associated with the diseases. These specific patterns can be diagnostic clues to distinguish them from other syndromes, such as craniofacial defects, and to remind ophthalmologists that such patients require additional dermatological and neurological examinations and referral. Moreover, a thorough evaluation of ocular conditions is imperative for early interventions.
Collapse
Affiliation(s)
- Yan Yan
- Department of Ophthalmology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Siyi Zhang
- Department of Ophthalmology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Henghua Zhou
- Department of Pathology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yixiong Zhou
- Department of Ophthalmology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yao Fu
- Department of Ophthalmology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Epibulbar complex and osseous choristoma: Clinicopathological study with interesting associations. Ann Med Surg (Lond) 2018; 36:135-141. [PMID: 30510760 PMCID: PMC6258243 DOI: 10.1016/j.amsu.2018.10.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/21/2018] [Indexed: 01/24/2023] Open
Abstract
Materials and methods A retrospective cohort study of cases with tissue diagnosis of epibulbar choristoma in 2 centers presenting during the period: 2000–2016 with focus on cases of complex and osseous choristoma. Demographic and clinical data were collected by the resident from medical records. The histopathological slides were reviewed by 2 pathologists and cases of complex and osseous choristoma were analyzed by biostatical staff. Results 120 epibulbar choristomas were identified. 13/120 patients (10.8%) with complex choristoma and 2/120 patients (1.7%) with osseous choristoma. 15 cases were further analyzed: 7 were males and 8 were females. Mean age at presentation was 7.6 year. Commonest location was temporal in 66.6%. The presence of smooth muscle component was associated with a larger size choristoma (p = 0.042). 73.3% had other ophthalmic manifestations (mostly eyelid anomalies) while 9 systemic associations (mostly Goldenhar's syndrome) were found in 8/13 cases of complex choristoma. Conclusion Epibulbar complex and osseous choristomas are rare. Histopathologically, the presence of smooth muscle significantly correlates with the lesion size. Complex choristoma is more likely to be associated with systemic manifestations. Further genetic studies for this condition are recommended. Choristomas are congenital tumors that may affect the epibulbar area. They arise from ectopic pluripotent cells differentiating into simple or complex choristoma. We present our cases to highlight interesting ophthalmic and/or systemic associations. This might open the door for future molecular genetic testing. Significant association is found between smooth muscle component and larger size choristoma.
Collapse
|
7
|
Zhang Z, Yang Z, Pan Q, Qin X, Deng Y, Cao Y. Epibulbar complex cartilaginous choristoma: A distinctive clinicopathological case series and literature review. Medicine (Baltimore) 2018; 97:e9902. [PMID: 29443763 PMCID: PMC5839851 DOI: 10.1097/md.0000000000009902] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To newly describe the clinical and histopathological characteristics of epibulbar complex cartilaginous choristoma incidentally observed in a series of pterygium excision patients.Noncomparative case series with chart review of 8 patients.During a 4-year period, we identified 8 cases of conventional unilateral nasal subpterygial cartilaginous choristoma in 1799 pterygium patients and analyzed their clinicopathological features. The incidence rate of this entity is 0.44% in pterygium patients. All of the cartilaginous choristomas were buried deep in the caruncle, covered by the pterygium, and embedded in tenon facia tissue. Its clinicopathological characteristics include hyaline cartilaginous tissue that is surrounded by fibrous connective tissue and smooth muscle bundles. S-100 protein-staining specifically revealed chondrocytes embedded within chondroid matrix.Epibulbar complex cartilaginous choristoma covered by pterygia and predominantly observed in the older population is rare. The lesions were buried deep in the caruncle, covered by the pterygium and embedded in tenon fascia tissue. These findings are inconsistent with those in previous reports.
Collapse
Affiliation(s)
- Zongduan Zhang
- Jinhua Eye Hospital, Jinhua, ZheJiang
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhengwei Yang
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qintuo Pan
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoyi Qin
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yuxuan Deng
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | | |
Collapse
|
8
|
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.
Collapse
|
9
|
Nishimoto S, Sotsuka Y, Kawai K, Ide YH, Kakibuchi M. Congenital lipomatous tumour, presented as a polypoidal projection on upper eyelid. J Surg Case Rep 2017; 2017:rjx139. [PMID: 28775837 PMCID: PMC5534016 DOI: 10.1093/jscr/rjx139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 07/01/2017] [Indexed: 11/23/2022] Open
Abstract
A Japanese baby was born with a polypoidal projection with hair, on the lateral corner of upper eyelid. The tumour had extent to bulbar sub-conjunctival area. He presented no other malformation nor pathological symptoms. There was no sign of association with Goldenhar, hemifacial macrosomia, epidermal nevus or linear nevus sebaceous syndromes. The tumour was resected at his age of 4 months. The ocular conjunctiva was incised but not excised. Histopathologically, it was mainly consisted of multi-lobuled mature adipose tissue, dense fibrous tissue was observed at the centre of mass, assumed to be the link of palpebral tarsal plate to lateral canthal ligament. As for the location and component, the tumour was diagnosed as a lipomatous hamartoma. Detached tarsal plate was reattached to the lateral canthal ligament. Satisfactory result was achieved aesthetically and functionally. Congenital lipomatous hamartoma, with protuberant appendage appearance on eyelid, without syndromic association, is presented.
Collapse
Affiliation(s)
- Soh Nishimoto
- Department of Plastic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Yohei Sotsuka
- Department of Plastic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Kenichiro Kawai
- Department of Plastic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshi-Hiro Ide
- Department of Surgical Pathology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Masao Kakibuchi
- Department of Plastic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| |
Collapse
|
10
|
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
| |
Collapse
|
11
|
Mittal R, Tripathy D. Respiratory (choristomatous) cyst of the conjunctiva. Can J Ophthalmol 2016; 51:e184-e187. [DOI: 10.1016/j.jcjo.2016.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/28/2016] [Accepted: 05/28/2016] [Indexed: 11/27/2022]
|
12
|
AlAkeely AG, Alkatan HM, Alsuhaibani AH, AlKhalidi H, Safieh LA, Coupland SE, Edward DP. Benign reactive lymphoid hyperplasia of the conjunctiva in childhood. Br J Ophthalmol 2016; 101:933-939. [PMID: 27899370 DOI: 10.1136/bjophthalmol-2016-309030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 11/02/2016] [Accepted: 11/08/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND/AIM Our aim is to the report the clinical and histopathological features of benign reactive lymphoid hyperplasia (BRLH) of the conjunctiva in children and the outcomes of treatment. METHODS A retrospective chart review was performed for children aged 0-18 years, diagnosed with conjunctival BRLH from January 2000 to December 2013 at two large ophthalmology hospitals in the Middle East. Data were collected on patient demographics, features of the lesions, the site of the lesion, location, adnexal involvement, lymph nodes involvement, local spread, histopathology and molecular genetic studies of the cases (if available), outcomes of treatment and recurrence. RESULTS There were 24 patients with lymphoid lesions classified as conjunctival BRLH during the 12-year period evaluated in this study. The mean age at diagnosis was 11.6 years. Twenty-three patients were males (96%). Systemic medical history included three patients with bronchial asthma, one patient with Down's syndrome, one patient with generalised skeletal malformation and one patient with gastritis. The initial uncorrected visual acuity was 20/30 or better in 93.5% of the eyes. At presentation, the tumour was unilateral in 12 cases (50%). The conjunctival mass was located on the bulbar conjunctiva in all cases. The mass was present nasally in 96% of lesions. No cases (that were tested) had an infectious aetiology. PCR demonstrated monoclonality suggestive of lymphoma in two cases; however, this did not alter the final diagnosis as BRLH per histopathological criteria and clinical course, CONCLUSIONS: All investigated cases of paediatric conjunctival BRLH had a benign clinical course with no local or systemic dissemination and a male predominance. Recurrence was rare, and in our cohort, it was not associated with malignant transformation.
Collapse
Affiliation(s)
| | - Hind M Alkatan
- Department of Ophthalmology, King Saud University Medical City, Riyadh, Saudi Arabia.,Department of Pathology, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Adel H Alsuhaibani
- Department of Ophthalmology, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hisham AlKhalidi
- Department of Pathology, King Saud University Medical City, Riyadh, Saudi Arabia
| | | | - Sarah E Coupland
- Department of Cellular Pathology, Royal Liverpool University Hospital, UK
| | - Deepak P Edward
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, USA
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Abstract
PURPOSE To report a rare case of isolated dermolipoma of the lower eyelid. DESIGN Case report. RESULTS A young otherwise healthy girl presenting with a slowly progressive, painless lesion of the left lower eyelid of about 3 years' duration had undergone conservative management elsewhere for symptoms of intermittent, mild irritation associated with the mass without any significant benefit. Increase in the size of the lesion in the recent past had been noted. Mass excision with histopathology showed it to be consistent with a dermolipoma. CONCLUSIONS An eyelid dermolipoma is distinctly uncommon in occurrence. Nonetheless, it should be considered in the differential diagnosis of benign mass lesions of the eyelid.
Collapse
Affiliation(s)
- Devjyoti Tripathy
- Oculoplastics, Orbit & Ocular Oncology Services, LV Prasad Eye Institute , Bhubaneswar, Odisha , India and
| | | |
Collapse
|
15
|
Balci O, Oduncu A. A case of epibulbar osseous choristoma with review of literature. Int Ophthalmol 2014; 34:1145-8. [PMID: 24799346 DOI: 10.1007/s10792-014-9952-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 04/17/2014] [Indexed: 10/25/2022]
Abstract
Epibulbar osseous choristomas are rare congenital simple choristomas consisting of pure bone on the sclera. It is usually recognized in childhood and most often located in the superotemporal quadrant. A case of 7-year-old male who presented with a history of mass in the left eye was reported in this paper. The mass had been present since birth but had showed slight enlargement during the last 6 months. Examination revealed a 7 × 5 mm reddish, hard, and mobile mass located in the superotemporal quadrant. Excisional biopsy was done. On histopathological examination, excised mass was found to be composed of mature bony trabeculae enclosing osteocytes, and diagnosis of epibulbar osseous choristoma was made.
Collapse
Affiliation(s)
- Ozlem Balci
- Department of Ophthalmology, Faculty of Medicine, Maltepe University, Istanbul, Turkey,
| | | |
Collapse
|
16
|
Watson S, Sarris M, Kuishek M, McKelvie P, Figueria E, McCluskey P, Coroneo M, Wakefield D. Limbal dermoid epithelium shares phenotypic characteristics common to both hair epidermal and limbal epithelial stem cells. Curr Eye Res 2013; 38:835-42. [PMID: 23573994 DOI: 10.3109/02713683.2013.780625] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To determine putative limbal epithelial stem cell marker expression in human limbal dermoids compared to stem cell niches in normal limbus and hair follicles of normal human dermis. METHODS Human limbal dermoids (n = 7), normal skin (n = 2) and normal limbal (n = 7) tissue were examined. Immunohistochemistry was performed on paraffin embedded specimens using automated and manual immunostaining with primary antibodies to CK15, CK14, Cadherin-P (CDH3), Wnt-3, Wnt-4, Wnt-5a, Dickkopf (DKK)-3, Sox-2, Sox-10, Sox-13, PEDF, NGFR p75 and β-catenin. RESULTS Positive immunostaining was found for CK15, CK14, CDH3, NGFR p75, PEDF, Sox-2, Sox-10 and Wnt 4 in the basal dermoid epithelium, limbus and hair follicles. Suprabasal epithelium was immunostained with PEDF, Sox-2 and Wnt-4 in these tissues. The sebaceous and sweat glands, vascular endothelium and nerves of the limbal dermoid immunostained with PEDF and Sox-2. Sebaceous and sweat glands stained for Sox-10. DKK-3 immunostaining occurred in the dermoids' suprabasal epithelium and vascular endothelium but not in the limbus or hair follicle. CONCLUSION Human limbal dermoids share a similar antigenic expression profile similar to the basal limbal epithelium and to the stem cell niche of hair follicles. This supports the notion that limbal dermoids could have properties in common with limbal and/or dermal epithelial stem cells.
Collapse
|
17
|
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]
|
18
|
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]
|
19
|
Khan AO, Al-Hussein H, Al-Katan H. Osseous choristoma of the lateral canthus. J AAPOS 2007; 11:502-3. [PMID: 17644441 DOI: 10.1016/j.jaapos.2007.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2007] [Revised: 04/07/2007] [Accepted: 04/07/2007] [Indexed: 12/24/2022]
Abstract
Ocular osseous choristoma, a rare idiopathic benign deposit of bone, is typically a static epibulbar lesion that occurs sporadically in the supertemporal quadrant of an otherwise normal eye. The subject of this report is a unique U-shaped subcutaneous osseous choristoma that did not involve the eye itself but rather conformed to the right lateral canthus in an otherwise normal 2-year-old boy.
Collapse
Affiliation(s)
- Arif O Khan
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
| | | | | |
Collapse
|
20
|
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.
Collapse
Affiliation(s)
- Carol L Shields
- Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
| | | |
Collapse
|
21
|
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.
Collapse
Affiliation(s)
- Byoung Jin Kim
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | | |
Collapse
|
22
|
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.
Collapse
Affiliation(s)
- Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA
| | | | | | | |
Collapse
|
23
|
Gayre GS, Proia AD, Dutton JJ. Epibulbar Osseous Choristoma: Case Report and Review of the Literature. Ophthalmic Surg Lasers Imaging Retina 2002. [DOI: 10.3928/1542-8877-20020901-11] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
24
|
Zagelbaum BM, Stroh EM, Perry HD, Donnenfeld ED, Cossari AJ. Corneal Perforation in a Premature Infant. J Refract Surg 1995; 11:96-8. [PMID: 7634149 DOI: 10.3928/1081-597x-19950301-08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Few cases of corneal perforation in a premature infant have been described in the literature. METHODS Identical twins were born at 30-weeks gestation. One twin developed a corneal epithelial defect, infiltration, and perforation with extrusion of intraocular contents, requiring an emergency penetrating keratoplasty. The second twin developed a progressive corneal opacity, requiring a lamellar keratectomy. RESULTS After penetrating keratoplasty, the patient developed absolute glaucoma with buphthalmos, leading to enucleation. The twin's lamellar keratectomy specimen proved to be a dermoid. CONCLUSIONS One must be aware of the danger of the development of spontaneous corneal perforation with extrusion of intraocular contents in premature infants presenting at birth with an epithelial defect.
Collapse
Affiliation(s)
- B M Zagelbaum
- Department of Ophthalmology, North Shore University Hospital, Manhasset, NY 11030, USA
| | | | | | | | | |
Collapse
|
25
|
Roth DB, Shields JA, Shields CL, Eagle RC. Lacrimal gland choristoma of the conjunctiva simulating a squamous cell carcinoma. J Pediatr Ophthalmol Strabismus 1994; 31:62-4. [PMID: 8195969 DOI: 10.3928/0191-3913-19940101-16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- D B Roth
- Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pa. 19107
| | | | | | | |
Collapse
|
26
|
Oakman JH, Lambert SR, Grossniklaus HE. Corneal dermoid: case report and review of classification. J Pediatr Ophthalmol Strabismus 1993; 30:388-91. [PMID: 8120746 DOI: 10.3928/0191-3913-19931101-11] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J H Oakman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Ga
| | | | | |
Collapse
|
27
|
Wuebbolt GE, Zuercher M, O'Donnell B, Collin R. Epithelial implantation cysts of the upper eyelid after lid-lowering procedures. Ophthalmology 1993; 100:1289-92. [PMID: 8371913 DOI: 10.1016/s0161-6420(93)31486-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
PURPOSE Epithelial inclusion cysts are benign lesions that have been described after intraocular and intraorbital surgery or trauma. The authors determine the rate of occurrence and characteristics of epithelial implantation cysts after upper eyelid-lowering procedures using a posterior conjunctival incision. METHOD The records of 109 upper eyelid-lowering cases over a 9-year period that had an internal incision were reviewed retrospectively. Any cysts removed were sent for histopathologic examination. RESULTS The incidence of cyst development was found to be 2.75%. The cysts were small and remained under 4 mm over time. Histopathologic findings of the two epithelial cysts removed suggested a conjunctival origin. The development of cysts did not correlate with length and difficulty of the procedure. CONCLUSION Epithelial implantation cysts of the eyelid after posterior approach levator recession procedures are rare (2.75% incidence). However, they often require surgical excision due to their conspicuous location. Their origin is probably the conjunctival epithelium implanted while manipulating the conjunctival incision edge.
Collapse
Affiliation(s)
- G E Wuebbolt
- Adnexal Division, Moorfields Eye Hospital, London, England
| | | | | | | |
Collapse
|
28
|
Melki TS, Zimmerman LE, Chavis RM, Ellsworth R, O'Neill JF. A unique epibulbar osseous choristoma. J Pediatr Ophthalmol Strabismus 1990; 27:252-4. [PMID: 2246739 DOI: 10.3928/0191-3913-19900901-09] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The case of a 14-year-old girl found to have a unique epibulbar osseous choristoma attached to the sheath of the superior rectus muscle is recorded. The bony mass was palpable through the upper lid and by computerized tomography, it appeared densely calcified and noncystic. There was no ptosis or abnormality in ocular motility preoperatively or postoperatively.
Collapse
Affiliation(s)
- T S Melki
- Center for Sight, Georgetown University Medical Center, Washington, DC
| | | | | | | | | |
Collapse
|
29
|
Eijpe AA, Koornneef L, Bras J, Verbeeten B, Peeters FL, Zonneveld FW. Dermolipoma: characteristic CT appearance. Doc Ophthalmol 1990; 74:321-8. [PMID: 2257775 DOI: 10.1007/bf00145816] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Dermolipomas are choristomas usually located at the external canthus. Clinically they can be confused with dermoid cysts. Preoperative diagnosis of a dermolipoma is important because the surgical approach is less aggressive than for dermoid cysts. We describe the clinical aspects of ten patients with a dermolipoma and demonstrate the posterior extension of these lesions by CT.
Collapse
Affiliation(s)
- A A Eijpe
- Department of Ophthalmology, University of Amsterdam, The Netherlands
| | | | | | | | | | | |
Collapse
|
30
|
Hayasaka S, Sekimoto M, Setogawa T. Epibulbar complex choristoma involving the bulbar conjunctiva and cornea. J Pediatr Ophthalmol Strabismus 1989; 26:251-3. [PMID: 2795415 DOI: 10.3928/0191-3913-19890901-11] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A male infant was born with a fleshy mass between the temporal bulbar conjunctiva and cornea in the right eye. Four weeks after birth the patient underwent excision of the epibulbar tumor and a lamellar keratoplasty. Histopathologic examination of the excised tumor revealed cartilage, lobules of lacrimal gland, and adipose tissue, indicating an epibulbar complex choristoma. Although the graft remained almost completely transparent, right amblyopia ensued. Epibulbar complex choristoma involving the conjunctiva and cornea is a rare condition.
Collapse
Affiliation(s)
- S Hayasaka
- Department of Ophthalmology, Shimane Medical University, Izumo, Japan
| | | | | |
Collapse
|