Department of Ophthalmology, National Taiwan University Hospital, No 7, Chung-Shan S. Rd, Taipei 100, Taiwan.
Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan.
BMC Ophthalmol. 2019 Nov 12;19(1):223. doi: 10.1186/s12886-019-1234-7.
Epibulbar complex choristoma, a rare congenital epibulbar tumor, has many diverse forms. Reviewing the literature, it can present clinically as either a circumferential or isolated epibulbar mass, limbal tumor, lateral canthal mass, aggregate of ectopic cilia in the upper eyelid, eyelid mass mimicking chalazion, or lacrimal caruncle mass. The management depends on the extent of involvement, the risk of amblyopia, and cosmetic concerns. Here, we report an atypical presentation of epibulbar complex choristoma with simultaneous eyelid involvement.
A 1-month-old full-term boy was brought to our clinic with congenital epibulbar mass of the right eye with simultaneous eyelid involvement. Dilated fundus examination was unremarkable. Survey for linear nevus sebaceous Jadassohn was negative. Due to concerns of possible amblyopia and cosmetics, lamellar keratectomy, sclerotomy, and conjunctivoplasty were performed to remove the epibulbar lesion. The eyelid defect was reconstructed with 6-0 Vicryl sutures. Histopathological examination reported complex choristoma. Upon three-year follow-up, low astigmatism and favorable cosmetics results were achieved.
Congenital complex choristoma can present clinically as an epibulbar mass with eyelid involvement. The management depends on the extent of involvement, the risk of amblyopia, and cosmetic concerns. The method of eyelid reconstruction should be tailored according to the residual eyelid defect.
眼表复合性皮样瘤是一种罕见的先天性眼表肿瘤,具有多种不同的表现形式。通过文献回顾,其临床表现可以是环状或孤立的眼表肿块、角巩膜缘肿瘤、外眦部肿块、上眼睑异位睫毛团块、类似霰粒肿的眼睑肿块,或泪阜肿块。其处理取决于病变范围、弱视风险和美容需求。在此,我们报告一例同时累及眼睑的眼表复合性皮样瘤的非典型表现。
一名 1 个月大的足月男婴因右眼先天性眼表肿块伴同时累及眼睑而被带到我们的诊所。散瞳眼底检查未见明显异常。未发现线性痣样汗管角化病。由于担心可能存在弱视和美容问题,我们行板层角膜切除术、巩膜切开术和结膜成形术以切除眼表病变。用 6-0 薇乔缝线重建眼睑缺损。组织病理学检查报告为复杂的皮样瘤。在三年的随访中,患儿获得了低度散光和良好的美容效果。
先天性复杂皮样瘤可表现为眼表肿块伴眼睑累及。其处理取决于病变范围、弱视风险和美容需求。眼睑重建的方法应根据残留的眼睑缺损进行定制。