Angus Zachary George, McKelvie Penelope, Hardy Thomas G
Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.
Department of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.
Case Rep Ophthalmol. 2024 May 8;15(1):418-422. doi: 10.1159/000538824. eCollection 2024 Jan-Dec.
Epibulbar choristoma is a benign congenital lesion containing histologically normal-appearing tissue in an abnormal ectopic location. An epibulbar choristoma is classified as either epibulbar dermoid, dermolipoma, or complex choristoma based on histological examination. The case presented was a presumed epibulbar dermolipoma with no signs of ossification on imaging, examination, or intraoperatively until the specimen was examined histologically, clarifying the lesion as an epibulbar complex choristoma. Reassuringly, the presence of bone in such lesions should not change management.
A mother noticed a small fleshy mass on her 9-year-old daughter's superotemporal bulbar conjunctiva. The suspected epibulbar dermolipoma was confirmed with MRI and initially managed conservatively. Two years later, she was referred for apparent growth and cosmetic concerns, and she underwent surgical debulking.
We present this case for its unusual presentation and histological findings. Orbital surgeons should be aware of the possibility of ossification of epibulbar choristomas and avoid confusion with alternative diagnoses. Clarification of the latest classification system for epibulbar choristomas is provided.
眼球表面迷离瘤是一种良性先天性病变，在异常的异位位置含有组织学上外观正常的组织。根据组织学检查，眼球表面迷离瘤可分为眼球表面皮样瘤、皮样脂肪瘤或复合迷离瘤。本病例最初被推测为眼球表面皮样脂肪瘤，在影像学、检查或术中均未发现骨化迹象，直到对标本进行组织学检查，才明确该病变为眼球表面复合迷离瘤。令人欣慰的是，此类病变中骨的存在并不影响治疗方案。
一位母亲注意到她9岁女儿颞上侧球结膜上有一个小的肉质肿物。MRI证实为疑似眼球表面皮样脂肪瘤，最初采取保守治疗。两年后，因肿物明显增大和美观问题前来就诊，遂接受了手术切除。
我们展示该病例是因其不寻常的表现和组织学发现。眼眶外科医生应意识到眼球表面迷离瘤骨化的可能性，避免与其他诊断混淆。本文还提供了眼球表面迷离瘤最新分类系统的说明。
