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Yu J, Eagle RC, Syed ZA. Epibulbar simple cartilaginous choristoma associated with unique pigmented multicystic component. Eur J Ophthalmol 2024; 34:NP101-NP104. [PMID: 38380886 DOI: 10.1177/11206721241234706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
PURPOSE To report an atypical presentation of an epibulbar simple cartilaginous choristoma with a unique pigmented multicystic component. CASE DESCRIPTION A 69-year-old African American female presented for evaluation of a right nasal epibulbar lesion that had progressed over the prior year. Slit-lamp evaluation revealed an immobile, mildly pigmented multicystic lesion measuring 6.0 × 4.5 mm that involved the nasal bulbar conjunctiva and the plica semilunaris. The lesion appeared benign, without feeder vessels or features of epithelial dysplasia. Given its recent growth and the patient's cosmetic concerns, the lesion was excised with ocular surface reconstruction. Histopathological evaluation disclosed a well-circumscribed nodule of well-differentiated cartilage in the substantia propria, consistent with a simple cartilaginous choristoma. The overlying conjunctival stroma contained multiple cysts lined by focally pigment epithelium. The patient recovered well from surgery, with satisfactory cosmetic results. CONCLUSIONS Our case of epibulbar simple cartilaginous choristoma includes a prominent superficial component of pigmented epithelial cysts, which has not been previously reported in the literature. This augments our knowledge on the spectrum of presentations of cartilaginous choristomas and underscores the importance of histopathological evaluation for definitive diagnosis.
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Affiliation(s)
- Julia Yu
- Cornea Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ralph C Eagle
- Department of Pathology, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Zeba A Syed
- Cornea Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Yan Y, Zhang S, Zhou H, Zhou Y, Fu Y. Ophthalmic Manifestation and Pathological Features in a Cohort of Patients With Linear Nevus Sebaceous Syndrome and Encephalocraniocutaneous Lipomatosis. Front Pediatr 2021; 9:678296. [PMID: 34095036 PMCID: PMC8177968 DOI: 10.3389/fped.2021.678296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose: This study aimed to figure out the association between ophthalmic and pathological features in patients with Linear Nevus Sebaceous Syndrome (LNSS) and in patients with Oculoectodermal Syndrome-Encephalocraniocutaneous Lipomatosis (OES-ECCL). Methods: It is a retrospective, non-consecutive, observational case series. Twenty-seven patients (12 with LNSS and 15 with OES-ECCL, 41 eyes) referred to the Department of Ophthalmology of the Shanghai Ninth People's Hospital between 2000 and 2020 were included. The mean age of the study population for the first-time consult was 5.7 years, ranging from 3 months to 34 years. Clinical notes, pathological records, and imaging findings were reviewed in all the patients. Results: Fourteen (51.9%) cases showed bilateral ocular involvement. Epibulbar choristomas were seen in all the patients. All the lesions involved the conjunctiva and cornea simultaneously. Multiple lesions were observed in 12 eyes. Of the 14 excised lesions, 11 were found to be complex choristomas. Further, 24 (89%) patients had eyelid coloboma. Also, 13 patients (48%) were diagnosed with strabismus, and 12 patients (44%) had abnormal fundus imaging, including optic nerve hypoplasia. Conclusions: LNSS and OES-ECCL shared common ophthalmic features, including epibulbar choristomas with distinctive characteristics, eyelid coloboma, strabismus, and optic nerve hypoplasia. The complex choristoma was found to be associated with the diseases. These specific patterns can be diagnostic clues to distinguish them from other syndromes, such as craniofacial defects, and to remind ophthalmologists that such patients require additional dermatological and neurological examinations and referral. Moreover, a thorough evaluation of ocular conditions is imperative for early interventions.
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Affiliation(s)
- Yan Yan
- Department of Ophthalmology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Siyi Zhang
- Department of Ophthalmology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Henghua Zhou
- Department of Pathology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yixiong Zhou
- Department of Ophthalmology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yao Fu
- Department of Ophthalmology, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Huang ZJ, Zheng JL, Zheng DZ, Huang DG, Tian DP, Chen WQ. Pediatric episcleral osseous choristomas: a case report. Int J Ophthalmol 2020; 13:1671-1674. [PMID: 33078121 PMCID: PMC7511370 DOI: 10.18240/ijo.2020.10.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/18/2020] [Indexed: 02/05/2023] Open
Affiliation(s)
- Zi-Jing Huang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
| | - Jian-Long Zheng
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
| | - De-Zhi Zheng
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
| | - Ding-Guo Huang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
| | - Dong-Ping Tian
- Department of Pathology, Shantou University Medical College, Shantou 515041, Guangdong Province, China
| | - Wei-Qi Chen
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
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Hsia Y, Lien HC, Wang IJ, Liao SL, Wei YH. Epibulbar complex choristoma with simultaneous involvement of eyelid: a case report. BMC Ophthalmol 2019; 19:223. [PMID: 31718612 PMCID: PMC6852968 DOI: 10.1186/s12886-019-1234-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 11/01/2019] [Indexed: 11/22/2022] Open
Abstract
Background 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. Case presentation 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. Conclusions 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.
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Affiliation(s)
- Yun Hsia
- Department of Ophthalmology, National Taiwan University Hospital, No 7, Chung-Shan S. Rd, Taipei 100, Taiwan
| | - Huang-Chun Lien
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan.,College of Medicine, National Taiwan University, Taipei, Taiwan
| | - I-Jong Wang
- Department of Ophthalmology, National Taiwan University Hospital, No 7, Chung-Shan S. Rd, Taipei 100, Taiwan.,College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shu-Lang Liao
- Department of Ophthalmology, National Taiwan University Hospital, No 7, Chung-Shan S. Rd, Taipei 100, Taiwan.,College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Hsuan Wei
- Department of Ophthalmology, National Taiwan University Hospital, No 7, Chung-Shan S. Rd, Taipei 100, Taiwan.
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Herdiana TR, Takahashi Y, Valencia MRP, Ana-Magadia MG, Ishikawa E, Kakizaki H. Epibulbar osseous choristoma within a dermolipoma: case report and literature review. Orbit 2018; 38:407-411. [PMID: 30430897 DOI: 10.1080/01676830.2018.1539110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
A healthy 18-year-old girl presented with a superotemporal epibulbar mass that was present since birth. Computed tomography revealed a cystic mass with fat-like low-density and a central oval-shaped mass that was isodense to the bone in the superotemporal region of the globe. Histopathology of the excised tumour revealed osseous choristoma and dermolipoma. Our review of literature yielded nine reported cases of epibulbar osseous choristoma within a dermolipoma and we reviewed these cases.
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Affiliation(s)
- Tri Rejeki Herdiana
- Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital , Aichi , Japan
| | - Yasuhiro Takahashi
- Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital , Aichi , Japan
| | - Ma Regina Paula Valencia
- Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital , Aichi , Japan
| | - Marian Grace Ana-Magadia
- Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital , Aichi , Japan
| | - Eri Ishikawa
- Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital , Aichi , Japan
| | - Hirohiko Kakizaki
- Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital , Aichi , Japan
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Zhang Z, Yang Z, Pan Q, Qin X, Deng Y, Cao Y. Epibulbar complex cartilaginous choristoma: A distinctive clinicopathological case series and literature review. Medicine (Baltimore) 2018; 97:e9902. [PMID: 29443763 PMCID: PMC5839851 DOI: 10.1097/md.0000000000009902] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
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.
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Affiliation(s)
- Zongduan Zhang
- Jinhua Eye Hospital, Jinhua, ZheJiang
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhengwei Yang
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qintuo Pan
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoyi Qin
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yuxuan Deng
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
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Ojha PR, Deshpande AH, Gargade CB, Nigam JS. Epipalpebral conjunctival chondroid choristoma: Interesting developmental anomaly presenting in an adult. Indian J Ophthalmol 2017; 65:613-614. [PMID: 28724821 PMCID: PMC5549416 DOI: 10.4103/ijo.ijo_39_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ocular choristomas are uncommon lesions chiefly presenting in children. Choristomas may contain dermal and epidermal components, muscle, cartilage, bone, etc. They are usually seen in epibulbar conjunctiva, but epipalpebral location is uncommon. We present a case of epipalpebral chondroid choristoma presenting in an adult patient.
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Affiliation(s)
- Pushpanjali R Ojha
- Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands, India
| | - Archana Hemant Deshpande
- Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands, India
| | - Chitrawati Bal Gargade
- Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands, India
| | - Jitendra Singh Nigam
- Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands, India
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Jakobiec FA, Stagner AM, Katowitz WR, Eagle RC. A microanatomic abnormality of the lacrimal gland associated with Goldenhar syndrome. Surv Ophthalmol 2016; 61:654-63. [DOI: 10.1016/j.survophthal.2016.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/03/2016] [Accepted: 02/05/2016] [Indexed: 11/26/2022]
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