Department of Ophthalmology, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA.
Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, USA.
Orbit. 2022 Apr;41(2):250-252. doi: 10.1080/01676830.2020.1831024. Epub 2020 Oct 4.
A 78-year-old Caucasian male presented with diplopia and decreased vision in the left eye for 1 month, in addition to a painless fleshy lesion in the inner corner of the left eye for 3-month duration. His best-corrected visual acuity was 20/40 and 20/50. Slit lamp examination revealed a left medial conjunctival and caruncular lesion, measuring 6 mm by 4 mm. Histology of the excised mass showed a cellular submucosal spindle cell neoplasm without cytologic atypia and rare mitoses, immunohistologically diffusely positive for CD34 and STAT6, and negative for SMA. Based on these findings, solitary fibrous tumor was diagnosed. With the combined diagnostic power of light microscopy and immunohistochemistry, SFTs are diagnosed increasingly and more accurately in the orbit. With this first case report of a caruncular SFT, we believe that SFTs should remain on the differential for mesenchymal tumors of the conjunctiva and caruncle.
一位 78 岁的白种男性，左眼出现复视和视力下降 1 个月，左眼内角无痛性肉质病变 3 个月。他的最佳矫正视力为 20/40 和 20/50。裂隙灯检查显示左眼内侧结膜和泪阜有病变，大小为 6 毫米乘 4 毫米。切除肿块的组织学显示为细胞性黏膜下梭形细胞肿瘤，无细胞异型性和罕见有丝分裂，免疫组织化学 CD34 和 STAT6 弥漫阳性，SMA 阴性。根据这些发现，诊断为孤立性纤维瘤。通过光镜和免疫组织化学的联合诊断能力，SFT 在眼眶中的诊断越来越准确。通过首例泪阜 SFT 的病例报告，我们认为 SFT 应作为结膜和泪阜间叶性肿瘤的鉴别诊断之一。
