Safe Management of Dermolipomas

Early results of surgical management of conjunctival dermolipoma: partial excision and free conjunctival autograft

“…However, for symptomatic or cosmetically unacceptable large visible masses in the primary position, excision for symptom and cosmetic improvement may be employed. Surgical resection of the conjunctival mass itself is not typically considered a complicated procedure; however, much care should be taken when managing patients with dermolipoma because cases of diplopia, forniceal shrinkage, strabismus, blepharoptosis and keratoconjunctivitissicca have been reported after surgery, which can occur following aggressive resection by damaging the lateral and superior rectus muscle, the levator muscle of the upper lid and the lacrimal gland 4 5 7 8 10. Therefore, resection of dermolipoma should be treated more conservatively, with limited debulking of the anterior portion of the tumour.…”

“…Most previous reports of dermolipoma surgery focus on the serious complications arising from aggressive resection as mentioned above 4 5 7 8 10. To avoid these dangerous complications, they recommend minimal resection of only the anterior portion of the tumour, with care taken to preserve the majority of the conjunctiva to prevent symblepharon and restrictive motility disorder.…”

Inferomedial Dermolipoma With Ectopic Lacrimal Gland

“…Dermolipomas are believed to arise from abnormal sequestration of surface ectoderm along embryonic lines of closure between the third and fifth week of gestation. 1 Clinically, a dermolipoma is characterized as a soft yellow sessile mass located just deep in the superotemporal bulbar and forniceal conjunctiva in children, best appreciated during adduction. They are usually present at birth; however, some are not detected until adulthood owing to their peripheral location and typical asymptomatic nature.…”

“…Surgery should be undertaken cautiously as damage to adjacent ocular adnexal structures can occur such as the lateral rectus muscle, lacrimal gland, and levator aponeurosis leading to complications of diplopia, keratoconjunctivitis sicca, and blepharoptosis, respectively. 2 In the largest series to date, Fry et al 1 describe 45 patients with dermolipomas, all of which were found to arise temporally. Mcnabb et al 2 and Kim et al 3 also found the dermolipoma to be in the temporal orbit in all patients studied in their series of 35 and 27 patients, respectively.…”

Dermolipoma e prolapso de gordura orbital: duas entidades distintas

“…Muitos relatam complicações com a retirada do dermolipoma, como simbléfa-ro, ptose, diplopia de difícil tratamento, lesão da glândula lacrimal ou do sistema de drenagem lacrimal e outros sintomas indesejáveis (10)(11)(12)(13) . Portanto, deve-se atentar para o fato do real benefício que o paciente irá conquistar com a cirurgia.…”