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

Abstract

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 Choristoma Containing Bone: A Case Report and Closer Look at Classifications

“…The ossification was not apparent on imaging, clinical examination, or intraoperatively. This is in contrast to similar reported cases which had more apparent bone being detected through such methods [4‒7]. The initial MRI 2 years prior to re-presentation and debulking showed typical epibulbar dermolipoma morphology with a high T1-weighted fat signal similar to that of subcutaneous fat, rather than orbital fat (Fig.…”

“…This lesion would thus be regarded as an epibulbar complex choristoma containing bone. Similar lesions in the literature have been referred to as epibulbar dermolipoma containing bone, epibulbar osseous choristoma, or similar [4‒7]. In concordance with the latest WHO classification system, epibulbar complex choristoma is the preferred terminology for these lesions.…”