Bilateral symmetrical epibulbar osseous choristoma

Epibulbar osseous choristoma with dermolipoma: A case report and review of literature

BACKGROUND

A choristoma is defined as a growth of histologically normal tissue in an abnormal location. Epibulbar osseous choristoma is the rarest type among all ocular choristoma with less than 100 cases reported. Here, we report a case of epibulbar osseous choristoma combined with dermolipoma and a literature review.

METHODS

A 15-year-old female patient presented with an accidentally found subconjunctival mass in her left eye. Slit lamp examination revealed a 10 × 10 mm elevated, sigmoid-shaped mass in the supratemporal quadrant of the bulbar conjunctiva. We performed a debulking excisional biopsy of the mass.

RESULTS

The pathology confirmed osseous tissue surrounded by mature adipose tissue. At 1 week after the operation, the wound was clear and the patient was satisfied with the treatment. A systematic literature review of 14 previously published cases taken from PubMed dating back to 1987 along with ours was undertaken. The average age at presentation was 11.6 years and there was a female preponderance with 10 cases being female and the other 5 cases being male. Supratemporal conjunctiva was the most common site of presentation. There was no systemic disease associated with any of the cases. Since it is a benign tumor, it can be managed by observation, but if necessary, it can be treated by surgical removal.

CONCLUSION

In pediatric subconjunctival mass, particularly located in supratemporal quadrant of bulbar conjunctiva, osseous choristoma should be considered in the differential diagnosis. Pre-operative CT scans will helpful to not also reduce complication with surgical excision but also helpful in prediction of diagnosis and prognosis.

Epibulbar complex and osseous choristoma: Clinicopathological study with interesting associations

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.

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Choristomas are congenital tumors that may affect the epibulbar area.

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They arise from ectopic pluripotent cells differentiating into simple or complex choristoma.

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We present our cases to highlight interesting ophthalmic and/or systemic associations.

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This might open the door for future molecular genetic testing.

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Significant association is found between smooth muscle component and larger size choristoma.

Epibulbar osseous choristoma: a photo essay case report

PURPOSE

To present the pre-, per- and postoperative features of epibulbar osseous choristoma.

METHODS

Case description including intraoperative imaging and histopathology.

RESULTS

A 32-year-old male patient presented with a lesion on his right eye, suggestive of an epibulbar dermolipoma. Excision of bony lesion was performed and revealed epibulbar osseous choristoma.

CONCLUSIONS

Epibulbar osseous choristoma is a rare and benign condition which can present with features similar to dermolipoma.

Epibulbar complex cartilaginous choristoma: A distinctive clinicopathological case series and literature review

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.

Epibulbar osseous choristoma

The topic of this case report is a rare subconjuctival osseous choristoma that corresponded to the left lateral sunconjunctiva and canthus. A 20-year-old man was asymptomatic when he arrived for the examination. His full ophthalmic examination was normal. Orbital computerized tomography was concordant with osseous lesion. Osseous choristomas are the rarest forms of ocular choristomas, they are usually being defined as sporadic, and they are found at the superior temporal region of the episclera. In our case, choristoma was in the lateral canthus of the left eye. We had administered surgical excision by reason of the patient's cosmetic requirement. We had noted that the lesion was adherent to conjunctiva but not to the sclera and the muscles. After surgical treatment, we saw mature heterotrophic osseous tissue in subconjunctival area and Haversian canals in compact bone tissue.

Dermolipoma of the lower eyelid

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.

A case of epibulbar osseous choristoma with review of literature

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.

Epibulbar osseous choristoma in 8 patients

PURPOSE

To describe the clinical features and histopathology of epibulbar osseous choristoma in a series of patients.

METHODS

Noncomparative case series with chart review of 8 patients.

RESULTS

At presentation, the mean age of the patients was 19 years (median, 19 years; range, 0.8-38 years), with 6 women and 2 men (6 Caucasian, 1 Hispanic, and 1 African American). There were no related systemic syndromes, and visual acuity was unaffected in all cases. The choristoma was superotemporal (n = 8, 100%), with epicenter located in the fornix (n = 8, 100%), deep to Tenon fascia (n = 8, 100%), and of yellow (n = 2, 25%), white (n = 2, 25%), or pink (n = 4, 50%) color. The mean basal dimension was 9 mm (median, 10 mm; range, 3.5-14 mm), and mean thickness was 4 mm (median, 4 mm; range, 2-5 mm). Four cases were managed with observation and 4 with surgical excision, revealing tumor base adherent to the episclera (n = 2, 50%) or loose within Tenon fascia (n = 2, 50%). There were no cases to demonstrate intrascleral involvement, growth, or recurrence.

CONCLUSIONS

Epibulbar osseous choristoma is a congenital lesion of mature bone located superotemporally in the fornix at the level of Tenon fascia or episclera in young patients.

Osseous choristoma of an extraocular muscle

Osseous choristoma is a benign lesion defined as normal osseous proliferative tissue in an ectopic site. We report what we believe to be the first osseous choristoma to replace extraocular muscle.

Epibulbar osseous choristoma: a report of two cases

Epibulbar osseous choristoma occurs rarely and is commonly mistaken for a dermoid or dermolipoma. We report two cases: an 8-year-old boy and a 79-year-old lady with epibulbar osseous choristomas where computed tomography showed an extraocular lesion in the temporal quadrant and diagnosis was confirmed by excision biopsy. The osseous component was adherent to the sclera in the young patient, while it was loosely attached to the surrounding tissue in the older patient. We believe that the 79-year-old lady is the oldest reported patient with an epibulbar osseous choristoma.

Osseous choristoma of the lateral canthus

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.