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

• Published in: Case reports in ophthalmology Vol. 15; no. 1; pp. 418 - 422
• Main Authors: Angus, Zachary George, McKelvie, Penelope, Hardy, Thomas G.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 08.05.2024; Karger Publishers
• Subjects: Case Report; Case reports; choristoma; Classification; Conflicts of interest; epibulbar complex choristoma; epibulbar dermolipoma; Magnetic resonance imaging; ossification; Tumors; Epibulbar dermolipoma; Epibulbar complex choristoma; Choristoma; Ossification
• DOI: 10.1159/000538824
• ISSN: 1663-2699

Abstract Introduction: Epibulbar choristoma is a benign congenital lesion containing histologically normal-appearing tissue in an abnormal ectopic location. An epibulbar choristoma is classified as either epibulbar dermoid, dermolipoma, or complex choristoma based on histological examination. The case presented was a presumed epibulbar dermolipoma with no signs of ossification on imaging, examination, or intraoperatively until the specimen was examined histologically, clarifying the lesion as an epibulbar complex choristoma. Reassuringly, the presence of bone in such lesions should not change management. Case Presentation: A mother noticed a small fleshy mass on her 9-year-old daughter’s superotemporal bulbar conjunctiva. The suspected epibulbar dermolipoma was confirmed with MRI and initially managed conservatively. Two years later, she was referred for apparent growth and cosmetic concerns, and she underwent surgical debulking. Conclusion: We present this case for its unusual presentation and histological findings. Orbital surgeons should be aware of the possibility of ossification of epibulbar choristomas and avoid confusion with alternative diagnoses. Clarification of the latest classification system for epibulbar choristomas is provided.