Alkharashi Majed, Alkatan Hind M, Alhumidi Ahmed A, Otaif Wael
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2022 Aug;97:107441. doi: 10.1016/j.ijscr.2022.107441. Epub 2022 Jul 21.
Ocular myxomas are very rare and can involve the orbit, eyelids, and conjunctiva. Conjunctival myxoma can be misdiagnosed as amelanotic nevus, conjunctival cyst, or ocular surface squamous neoplasia, among others. They can appear as an isolated lesion or can be associated with systemic manifestations as part of the Carney complex or Zollinger-Ellison syndrome.
We describe a 64-year-old healthy male who presented with a right eye painless peri-limbal salmon-colored patch lesion in the infero-temporal bulbar conjunctiva over a period of 2 years. There was no of ocular trauma or surgery and no effect on vision. The mass was not tender, raised, and mobile with fine intrinsic vascularity. Excisional biopsy with the presumed diagnosis of lymphoma revealed a typical sub-conjunctival myxoma.
The recognition of ocular myxoma necessitates systemic evaluation to rule out possible associated cardiac myxoma in Carney complex, thus can prevent life-threatening events. The excised mass in our patient showed an area of pseudo-elastotic degeneration, which has further complicated the clinical appearance of the lesion, however, the color, and consistency of the mass were highly suspicious of lymphoma. The diagnosis of myxoma by histopathology was helpful especially in presence of atypical appearance such as in our case.
The histopathological characteristics of conjunctival myxoma can aid in the diagnosis. The lesion in our case was associated with focal severe pseudo-elastotic degeneration and prominent salmon-patch appearing area thus was initially misdiagnosed clinically as a conjunctival lymphoma.
眼部黏液瘤非常罕见，可累及眼眶、眼睑和结膜。结膜黏液瘤可能被误诊为无色素痣、结膜囊肿或眼表鳞状细胞瘤等。它们可表现为孤立性病变，或作为卡尼综合征或佐林格 - 埃利森综合征的一部分与全身表现相关。
我们描述了一名64岁健康男性，其右眼颞下球结膜出现无痛性、鲑鱼色、边缘性斑块病变，持续2年。无眼外伤或手术史，视力无影响。肿块无压痛，不隆起，可活动，内部血管纤细。切除活检初步诊断为淋巴瘤，结果显示为典型的结膜下黏液瘤。
认识眼部黏液瘤需要进行全身评估，以排除卡尼综合征中可能相关的心脏黏液瘤，从而预防危及生命的事件。我们患者切除的肿块显示有假弹性变性区域，这使病变的临床表现更加复杂，然而，肿块的颜色和质地高度怀疑为淋巴瘤。通过组织病理学诊断黏液瘤很有帮助，尤其是在出现非典型外观的情况下，如我们的病例。
结膜黏液瘤的组织病理学特征有助于诊断。我们病例中的病变伴有局灶性严重假弹性变性和明显的鲑鱼色斑区域，因此最初在临床上被误诊为结膜淋巴瘤。
