Synthetic Fiber Granuloma Misdiagnosed as Chalazion in an 8-year-old Child

Purpose: We report a case of conjunctival synthetic fiber granuloma, which was misdiagnosed as chalazion. Case summary: An 8-year-old female patient, without any previous medical illness or ocular trauma history, visited our hospital with a prolonged mass-like lesion in the left lower palpebral conjunctiva. In her detailed medical history, she said that she often played with her doll's hair. The conjunctival mass first occurred 1 week before her visit to the private clinic. At that time, eye drop treatment was initiated under the diagnosis of chalazion. The child showed no improvement; thus, incision and curettage were performed. The mass in the conjunctiva continued to persist, so she was transferred to the hospital for a biopsy. Slit-lamp examination revealed a patterned agglomeration of fiber strands inside the mass. Complete excisional biopsy was performed under general anesthesia. Histopathological examination revealed a fibrous foreign body in the birefringence, with granulomatous inflammation surrounding it. The patient was diagnosed with synthetic fiber granuloma. Conclusions: Conjunctival synthetic fiber granulomas are easily mistaken as chalazion. If specific fibrous strands are entangled inside the mass on slit-lamp examination, diagnosis and treatment through therapeutic excisional biopsy are required under clinical suspicion.

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Lacrimal Caruncle Nevus with Papilloma

Case Reports in Ophthalmology ◽

10.1159/000480725 ◽

2017 ◽

Vol 8 (3) ◽

pp. 535-538

Author(s):

Eri Ishikawa ◽

Maria Suzanne Sabundayo ◽

Yasuhiro Takahashi ◽

Hirohiko Kakizaki

Keyword(s):

Case Report ◽

Histopathological Examination ◽

Clinical History ◽

Conjunctival Epithelium ◽

Slit Lamp ◽

Pathological Findings ◽

Slit Lamp Examination ◽

First Case ◽

Pigmented Lesion ◽

Intradermal Nevus

Purpose: The aim of this article is to report a case of lacrimal caruncle nevus with papilloma. Methods: This is a case report of a 39-year-old female with a progressively enlarging pigmented lesion on the left lacrimal caruncle. She had been aware of a raised whitish wart on the top of this pigmented lesion for several months before her initial visit. Slit lamp examination revealed a papillomatous lesion over a well-circumscribed, pigmented lesion on the left lacrimal caruncle. Results: The histopathological examination of the excised tumor disclosed 2 characteristic findings, which include nests of nevus cells within the dermis and papillomatous structures which had fibrovascular cores overlying squamous cell epithelia with variable levels of acanthosis. The findings were consistent with an intradermal nevus and a papilloma arising from the conjunctival epithelium of the nevus. Conclusion: This is the first case report of a lacrimal caruncle nevus with papilloma. The clinical history and pathological findings of this case underscore the fact that an intradermal nevus primarily occurred on the lacrimal caruncle, after which a papilloma arose from the epithelium of the nevus as a consequence of human papillomavirus autoinoculation.

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Giant Conjunctival Nevus in a 12-Year-Old Child

Case Reports in Ophthalmological Medicine ◽

10.1155/2017/8414352 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Edit Tóth-Molnár ◽

Eszter Vizvári ◽

Ákos Skribek ◽

András Vörös

Keyword(s):

Malignant Melanoma ◽

Histopathological Examination ◽

Bulbar Conjunctiva ◽

Rare Entity ◽

Slit Lamp ◽

Slit Lamp Examination ◽

Precise Diagnosis ◽

Compound Type ◽

Adequate Management ◽

Conjunctival Lesion

We describe a case of a giant conjunctival nevus presented in a 12-year-old girl with suspicious clinicomorphological appearance. The lesion was noticed by the parents at the age of 3 years as a “fleshy spot” on the bulbar conjunctiva. The lesion remained unchanged until approx. 6 months before recent admission. On slit-lamp examination, a large conjunctival lesion with variegate pigmentation and indistinct margins was detected on the superonasal part of the bulbar conjunctiva of the left eye. Intralesional cysts and vessels were detected with AS-OCT examination. Wide excision and cryotherapy to the scleral bed were performed and amniotic membrane graft was used to restore the ocular surface. Histopathological examination revealed compound type conjunctival nevus and disclosed any sign of malignancy. Although giant conjunctival nevus is a rare entity, precise diagnosis and adequate management are very important as it can be confused with malignant melanoma.

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Acute Spontaneous Multiple Ileal Tuberculosis Perforation: A Case Report

Bangladesh Journal of Infectious Diseases ◽

10.3329/bjid.v3i2.33835 ◽

2017 ◽

Vol 3 (2) ◽

pp. 52-54

Author(s):

Md Aminullah ◽

Fahmida Akter Rima ◽

Jamal Abdul Naser ◽

Farzana Kabir ◽

Waliullah Fuad ◽

...

Keyword(s):

Lymph Node ◽

Terminal Ileum ◽

Histopathological Examination ◽

Good Condition ◽

Intestinal Tuberculosis ◽

Granulomatous Inflammation ◽

Exploratory Laparotomy ◽

Excisional Biopsy ◽

Free Perforation ◽

Diffuse Abdominal Pain

A 18 years old boy presented with severe diffuse abdominal pain, constipation, abdominal distention, fever and diagnosed as a case of perforation as free gas noted under both dome of the diaphragm. After resuscitation, exploratory laparotomy was done and diagnosed as a case of multiple spontaneous leaky perforations of jejunum and ileum 25 to 30 cm from duodeno-Jejunal flexure (DJ) up to terminal ileum. Peritoneal toileting and excisional biopsy of the mesenteric lymph node were done. Operative and postoperative period were uneventful. Histopathological examination of the resected lymph node revealed granulomatous inflammation compatible with tuberculosis. Anti-tubercular therapy was started and continued for 6 months. Patient was discharged on the 12th postoperative day in a good condition. At 3 months of follow up the patient was asymptomatic and thriving well. Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. Bangladesh Journal of Infectious Diseases 2016;3(2):52-54

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Successful surgical management of large conjunctival nevus in a 10-year-old child with resection and amniotic membrane transplantation

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v17i3.755 ◽

2020 ◽

Vol 17 (3) ◽

pp. 324-328

Author(s):

Kiew Ing Tiong ◽

Shiivaa Manjare A/P Birapadian

Keyword(s):

Amniotic Membrane ◽

Histopathological Examination ◽

Surgical Excision ◽

Complete Resection ◽

Amniotic Membrane Transplantation ◽

Bulbar Conjunctiva ◽

Slit Lamp ◽

Slit Lamp Examination ◽

The Past ◽

Conjunctival Lesion

The purpose of this paper is to illustrate a case of large conjunctival nevus in a 10-year-old boy which was successfully treated with surgical excision and amniotic membrane transplant (AMT) reconstruction. The conjunctival nevus was initially noticed by the parents 1 year prior to presentation; they reported it had increased in size over the past 3 months. Slit-lamp examination revealed a pigmented conjunctival nevus measuring 5.5 mm vertically and 6.5 mm horizontally, with well-demarcated margins and presence of an intralesional cyst at the temporal bulbar conjunctiva, involving the limbus and encroaching onto the cornea. Complete resection of the conjunctival lesion and bulbar conjunctival reconstruction were performed. The histopathological examination showed conjunctival nevus. The wound healed well with vision of 6/6 and no recurrence. Surgical resection combined with AMT is a successful and an effective way to treat conjunctivalnevus.

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Late-onset malignant glaucoma

Latin American Journal of Ophthalmology ◽

10.25259/lajo_19_2019 ◽

2020 ◽

Vol 3 ◽

pp. 1

Author(s):

Ramiro José Daud ◽

Horacio Freile ◽

Mauricio Freile ◽

Soledad Mariano

Keyword(s):

Intraocular Pressure ◽

Case Report ◽

Acute Pain ◽

Late Onset ◽

Slit Lamp ◽

Normal Range ◽

Slit Lamp Examination ◽

Complete Occlusion ◽

Malignant Glaucoma ◽

The Right

A case report on a 49-year-old female with diagnoses of ocular hypertension in her left eye (LE) treated with 250 mg/day acetazolamide for 2 years. During the slit-lamp examination, complete occlusion of both iridocorneal angles was detected. Intraocular pressure (IOP) was 10 and 35 mmHg in the right eye and LE, respectively. Phacotrabeculectomy was performed in the LE. After 1 month of the procedure, the patient developed a slowly progressive miopization from −1 to −3 diopters (D) the following months. Approximately 3 months after surgery, the patient developed an episode of acute pain, athalamia, and IOP 45 mmHg in her LE. Late-onset malignant glaucoma was suspected and the patient was treated with topical hypotensive and cycloplegic agent until a prompt vitrectomy was performed. Deepening of the anterior chamber and restoration of IOP to normal range was obtained after surgery.

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Bilateral ocular surface squamous neoplasia: A study of 25 patients and review of literature

European Journal of Ophthalmology ◽

10.1177/11206721211007109 ◽

2021 ◽

pp. 112067212110071

Author(s):

Vijitha S Vempuluru ◽

Monalisha Pattnaik ◽

Neha Ghose ◽

Swathi Kaliki

Keyword(s):

Risk Factors ◽

Ocular Surface ◽

Histopathological Examination ◽

Topical Steroid ◽

Case Series ◽

Intraepithelial Neoplasia ◽

Excisional Biopsy ◽

Ocular Surface Squamous Neoplasia ◽

Retrospective Case

Purpose: To describe the risk factors, clinical presentation, management, and outcomes of patients with bilateral ocular surface squamous neoplasia (OSSN). Methods: Retrospective case series. Results: Of the 25 patients with bilateral OSSN, the mean age at diagnosis of OSSN was 31 years (median, 24 years; range, 2–60 years). Risk factors for bilateral OSSN included xeroderma pigmentosum ( n = 15, 60%), human immunodeficiency virus infection ( n = 3, 12%), conjunctival xerosis ( n = 1, 4%), and topical steroid use ( n = 1, 4%). There were no identifiable ocular or systemic risk factors in 7 (28%) patients. Presentation was synchronous in 14 (56%) and metachronous in 11 (44%) patients. Tumor morphology was bilaterally similar in 12 (48%) patients. Histopathological examination ( n = 36) revealed conjunctival intraepithelial neoplasia (CIN) grade 1 in 4 (8%); grade 2 in 7 (14%); carcinoma in situ in 5 (10%), and invasive carcinoma in 20 (40%). Primary management of OSSN ( n = 49) included excisional biopsy ( n = 31, 62%), topical immunotherapy (IFN α2B) ( n = 11; 22%), topical Mitomycin C (MMC) ( n = 3, 6%), enucleation ( n = 1, 2%), orbital exenteration ( n = 2, 4%), and plaque brachytherapy (PBT) ( n = 1, 2%). One patient was lost to follow-up after detection of tumor in the second eye. Recurrent tumors were noted in 16 (32%) eyes and binocular globe salvage was achieved in 16 (64%) patients at a mean follow up of 41 months (median 30 months; range, 1–164 months). Conclusion: OSSN occurrence can be synchronous or metachronous. Meticulous examination of the fellow eye is important for an early diagnosis of OSSN.

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Identification of a Novel Missense KRT12 Mutation in a Vietnamese Family with Meesmann Corneal Dystrophy

Case Reports in Ophthalmology ◽

10.1159/000506435 ◽

2020 ◽

Vol 11 (1) ◽

pp. 120-126

Author(s):

Pham Ngoc Dong ◽

Le Xuan Cung ◽

Tran Khanh Sam ◽

Do Thi Thuy Hang ◽

Doug D. Chung ◽

...

Keyword(s):

Sanger Sequencing ◽

Novel Mutation ◽

Family Members ◽

Corneal Dystrophy ◽

Slit Lamp ◽

Slit Lamp Examination ◽

Corneal Epithelial ◽

Epithelial Phenotype ◽

History Of ◽

Characteristic Features

Meesmann epithelial corneal dystrophy (MECD) is a rare dominantly inherited disorder that is characterized by corneal epithelial microcysts and is associated with mutations in the keratin 3 (KRT3) and keratin 12 (KRT12) genes. In this study, we report a novel mutation in the KRT12 gene in a Vietnamese pedigree with MECD. Slit-lamp examination was performed on each of the 7 recruited members of a Vietnamese family to identify characteristic features of MECD. After informed consent was obtained from each individual, genomic DNA was isolated from saliva samples and screening of KRT3and KRT12 genes was performed by Sanger sequencing. The proband, a 31-year-old man, complained of a 1-year history of eye irritation and photophobia. Slit-lamp examination revealed intraepithelial microcysts involving only the corneal periphery in each eye with clear central corneas and no stromal or endothelial involvement. Three family members demonstrated similar intraepithelial microcysts, but with diffuse involvement, extended from limbus to limbus. Sanger sequencing of KRT3 (exon 7) and KRT12 (exons 1 and 6) in the proband revealed a novel heterozygous KRT12 variant (c.1273G>A [p.Glu425Lys]) that was present in the three affected family members but was absent in the three family members with clear corneas. This study is the first report of a Vietnamese family affected with MECD, associated with an atypical peripheral corneal epithelial phenotype in the proband and a novel mutation in KRT12.

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Severe Corneal Morphological Alterations after Excimer Laser Surface Ablation for a High Astigmatism

Case Reports in Ophthalmology ◽

10.1159/000516311 ◽

2021 ◽

pp. 492-496

Author(s):

Anna M. Roszkowska ◽

Giovanni W. Oliverio ◽

Giuseppe A. Signorino ◽

Mario Urso ◽

Pasquale Aragona

Keyword(s):

Excimer Laser ◽

Corneal Stroma ◽

Corneal Topography ◽

Laser Surface ◽

Slit Lamp ◽

Slit Lamp Examination ◽

Morphological Alterations ◽

Surface Ablation ◽

Confocal Images

We report long-term alterations of anterior corneal stroma after excimer laser surface ablation for a high astigmatism. The patient claimed progressive visual loss in his right eye (RE) during the last 3 years after bilateral laser-assisted subepithelial keratectomy (LASEK) surgery. His examination comprised visual acuity (UDVA and CDVA), slit-lamp examination, corneal topography and tomography, AS-OCT, and confocal microscopy. The UDVA was 0.1 in his RE and 1.0 in the left eye. The CDVA in the RE was 0.8. The slit-lamp examination showed a stromal lesion in the inferior paracentral corneal zone, with multiple vertical tissue bridges and severe thinning. Corneal topography and tomography showed central flattening with inferior steepening and severe alteration in elevation maps. AS-OCT showed void areas in the anterior stroma with thinning of the underlying tissue, and confocal images were not specific. In this case, progressive corneal steepening and thinning that manifest topographically as inferior ectasia occurred in correspondence to the singular stromal alterations after LASEK.

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Progressive multifocal leukoencephalopathy in a patient with occult hypogammaglobulinemia experiencing bilateral visual impairment

European Journal of Ophthalmology ◽

10.1177/1120672121990535 ◽

2021 ◽

pp. 112067212199053

Author(s):

Sameera Hettipathirannahelage ◽

Sidath Wijetilleka ◽

Hugh Jewsbury

Keyword(s):

Progressive Multifocal Leukoencephalopathy ◽

Visual Impairment ◽

Demyelinating Disease ◽

Parietal Lobe ◽

Previous History ◽

White Matter Lesions ◽

Slit Lamp ◽

Slit Lamp Examination ◽

History Of ◽

Ishihara Test

Introduction: Progressive multifocal leukoencephalopathy (PML) is a rare, lethal, demyelinating disease classically seen in profoundly immunosuppressed individuals. It is caused by intracerebral infection by John Cunningham polyomavirus (JCV). We report a rare case of PML in a man with presumed immunocompetence at presentation experiencing bilateral painless visual impairment. Case Description: A 60-year-old man with a 3-week history of bilateral painless visual impairment attended our ophthalmology department. Unusually, he navigated around the room well and was able to read 4 of 13 Ishihara test plates in spite of a best-corrected visual acuity of counting fingers at 1 m bilaterally. Slit lamp examination, routine blood tests and optical coherence tomography (OCT) of the maculae and discs were unremarkable. Diffuse hyperintense white matter lesions on T2-weighted magnetic resonance imaging of the brain and detection of JCV within the parietal lobe tissue obtained by biopsy confirmed PML. Additional investigations identified an underlying hypogammaglobulinaemia, which may have initiated PML. He received intravenous immunoglobulin but passed away 2 months after diagnosis. Conclusions: To our knowledge this case is one of only a handful worldwide to describe PML developing in a patient with presumed immunocompetence at presentation – there was no previous history of recurrent, chronic, or atypical infections. There has only been one other report of visual symptoms presenting as the primary complaint. The case illustrates the importance of ruling out organic, central nervous system pathology in patients presenting with visual loss and normal objective visual function tests such as slit lamp examination and OCT.

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Nodular fasciitis on the zygomatic region: a rare presentation

Anais Brasileiros de Dermatologia ◽

10.1590/abd1806-4841.20132474 ◽

2013 ◽

Vol 88 (6 suppl 1) ◽

pp. 89-92 ◽

Cited By ~ 3

Author(s):

Ilner de Souza e Souza ◽

Mayra Carriijo Rochael ◽

Rogério Estevam Farias ◽

Roberto Bezerra Vieira ◽

Janaina Silva Tirapelle Vieira ◽

...

Keyword(s):

Benign Tumor ◽

Histopathological Examination ◽

Excisional Biopsy ◽

Nodular Fasciitis ◽

Rare Presentation ◽

Ki 67 ◽

Immunohistochemical Markers ◽

The Face ◽

Rare Location ◽

High Cellularity

Nodular fasciitis is a benign tumor, resulting from reactive proliferation composed of fibroblastic/myofibroblastic cells. Due to its rapid growth and high cellularity it may be mistaken for sarcoma. Despite the possibility of spontaneous regression, excision is the treatment of choice. A 24-year-old female patient presented with a nodule on the zygomatic region with 3 months of evolution. Excisional biopsy was performed. Histopathological examination associated with immunohistochemical markers HHF35, AML and Ki-67 allowed diagnostic confirmation. The main relevance of the case presented is its rare location, suggesting its inclusion among the differential diagnoses of tumor lesions on the face.

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