Primary Corneal Myxoma

Abstract

Primary corneal myxoma is extremely rare. It has only been reported on 2 previous occasions. Secondary corneal myxomas are more common, arising from corneal diseases such as infective keratitis, keratoconus, and bullous keratopathy. Myxomas occur commonly in other soft tissues such as the heart, paranasal sinuses, and muscles but can rarely present in periocular structures including the conjunctiva, orbit, and eyelid. Ours is only the third case of primary corneal myxoma reported in the literature and illustrates several unusual features. These include an inferonasal location between the corneal epithelium and Bowman layer and with no relationship to the corneal stroma, rapid tumor growth over a 3-month period, and no previous ocular trauma or conjunctival pathology. The histology of this lesion has an important part to play in the management of this condition as it determines the cellular origin, establishes a benign or malignant state, and helps with treatment and prognosis. One reported case of primary corneal myxoma recurred within 2 months after local resection. This was treated with bandage soft contact lens, and no recurrence had been reported since. Our case is now 12 months post op and has had no recurrence.

Clinical features and histopathological analysis of corneal myxoma

“…The eyes with corneal myxoma in our cohort had a whitish gelatinous material in the center of the cornea. This observation is consistent with the description in the literature 3 – 5 .…”

“…One eye had to be removed, one case experienced recurrence, and one eye experienced graft failure. The histological findings of the current study on corneal myxoma concur with previous literature 5 , 7 , 10 .…”

“…Since our cohort included cases with histologically confirmed corneal myxoma, we could not report how many were clinically suspected, however, no preoperative diagnosis of myxoma was documented in the files of all cases until a histopathology report was presented. Clinically suspect corneal myxoma needs to be differentiated from nodular fasciitis, Salzmann’s nodular degeneration, foreign body reaction, pannus, corneal amyloid, contact lens-induced epithelial microcysts or corneal pseudocysts, corneal keloid, dermoid tumor, corneal squamous cell carcinoma and sarcoma 5 , 7 , 10 . In many cases, it is confirmed following excision and histological review as in the current study.…”

Superficial Corneal Growth

“…It is often associated with chronic eye rubbing. 6 Histology of acute keratoconus shows epithelial and stromal edema breaks in the Bowman layer and Descemet membrane, which are not seen in myxoma. It is treated by surgical removal of central nodular scars, contact lenses, and in severe cases, corneal transplant.…”

Clinical appearance and pathological findings of conjunctival myxoma: Case report and literature review

“…1 , 2 , 3 Conjunctival myxoma, usually present in older people, was first described in 1913 by Magalif, followed by limited number of case reports. Other than conjunctiva, ocular myxoma could occur in the optic nerve, orbit, eyelid, and the cornea, 4 , 5 , 6 , 7 or develop with systemic diseases such as Zollinger-Ellison syndrome and Carney complex. In literature review, patient with Zollinger-Ellison syndrome could present with pancreatic gastrinoma, inter-atrial septal thickening, and conjunctival myxoma at the same time.…”