Rare Choristoma of the Tarsal Conjunctiva: Critical Inspection Prevents Unnecessary Mutilation

We report a case of a 26-year-old male patient with an incidental finding of a flesh-colored tumor with few vellus hairs on its surface, located on the fornix and the tarsal conjunctiva of the left lower eyelid. Histology of the biopsy showed a choristoma consisting of abundant vellus hairs, sebaceo...

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Published inCase reports in ophthalmology Vol. 13; no. 2; pp. 599 - 603
Main Authors Vetter, Viola Katharina, Correa-Perez, Maria E., Chaloupka, Karla, Mihic-Probst, Daniela
Format Journal Article
LanguageEnglish
Published Basel, Switzerland S. Karger AG 15.08.2022
Karger Publishers
Subjects
Biopsy
Case Report
Case reports
choristoma
Exocrine glands
Hair
hamartoma
Histology
Smooth muscle
tarsal choristoma
Tumors
vellus hair
Vellus hair
Case report
Tarsal choristoma
Choristoma
Hamartoma
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Abstract We report a case of a 26-year-old male patient with an incidental finding of a flesh-colored tumor with few vellus hairs on its surface, located on the fornix and the tarsal conjunctiva of the left lower eyelid. Histology of the biopsy showed a choristoma consisting of abundant vellus hairs, sebaceous glands, and sparse lacrimal gland tissue. Recognition of conjunctival vellus hairs is significant and raises the suspected diagnosis of choristoma, which can be confirmed by a small sample biopsy. A complete excision is unnecessary and possible surgical complications can be prevented. Choristomas of the tarsal conjunctiva are very rare and, to our knowledge, this is the first histological documentation of a choristoma containing vellus hair located on the tarsal conjunctiva. In addition, we review the histopathological findings of choristomas and their differential diagnoses.
AbstractList We report a case of a 26-year-old male patient with an incidental finding of a flesh-colored tumor with few vellus hairs on its surface, located on the fornix and the tarsal conjunctiva of the left lower eyelid. Histology of the biopsy showed a choristoma consisting of abundant vellus hairs, sebaceous glands, and sparse lacrimal gland tissue. Recognition of conjunctival vellus hairs is significant and raises the suspected diagnosis of choristoma, which can be confirmed by a small sample biopsy. A complete excision is unnecessary and possible surgical complications can be prevented. Choristomas of the tarsal conjunctiva are very rare and, to our knowledge, this is the first histological documentation of a choristoma containing vellus hair located on the tarsal conjunctiva. In addition, we review the histopathological findings of choristomas and their differential diagnoses.
We report a case of a 26-year-old male patient with an incidental finding of a flesh-colored tumor with few vellus hairs on its surface, located on the fornix and the tarsal conjunctiva of the left lower eyelid. Histology of the biopsy showed a choristoma consisting of abundant vellus hairs, sebaceous glands, and sparse lacrimal gland tissue. Recognition of conjunctival vellus hairs is significant and raises the suspected diagnosis of choristoma, which can be confirmed by a small sample biopsy. A complete excision is unnecessary and possible surgical complications can be prevented. Choristomas of the tarsal conjunctiva are very rare and, to our knowledge, this is the first histological documentation of a choristoma containing vellus hair located on the tarsal conjunctiva. In addition, we review the histopathological findings of choristomas and their differential diagnoses.We report a case of a 26-year-old male patient with an incidental finding of a flesh-colored tumor with few vellus hairs on its surface, located on the fornix and the tarsal conjunctiva of the left lower eyelid. Histology of the biopsy showed a choristoma consisting of abundant vellus hairs, sebaceous glands, and sparse lacrimal gland tissue. Recognition of conjunctival vellus hairs is significant and raises the suspected diagnosis of choristoma, which can be confirmed by a small sample biopsy. A complete excision is unnecessary and possible surgical complications can be prevented. Choristomas of the tarsal conjunctiva are very rare and, to our knowledge, this is the first histological documentation of a choristoma containing vellus hair located on the tarsal conjunctiva. In addition, we review the histopathological findings of choristomas and their differential diagnoses.
Author Vetter, Viola Katharina
Chaloupka, Karla
Correa-Perez, Maria E.
Mihic-Probst, Daniela
AuthorAffiliation b Department of Ophthalmology, University Hospital and University of Zurich, Zurich, Switzerland
a Institute of Pathology and Molecular Pathology, University Hospital and University of Zurich, Zurich, Switzerland
AuthorAffiliation_xml – name: b Department of Ophthalmology, University Hospital and University of Zurich, Zurich, Switzerland
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Keywords Vellus hair
Case report
Tarsal choristoma
Choristoma
Hamartoma
Language English
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References Chan S, Stewart CM. Epibulbar osseous choristoma: a rare find in the superior conjunctival tarsal plate of the upper eyelid. Ophthalmic Plast Reconstr Surg. 2020 Mar/Apr;36(2):e34–6.
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da Fonseca FL, Yamanaka PK, Lima PP, Matayoshi S. A 6-year-old girl with ectopic cilia and hypochromic nevus. Clin Ophthalmol. 2014;8:1259–61.
Roper GJ, Smith MS, Lueder GT. Congenital smooth muscle hamartoma of the conjunctival fornix. Am J Ophthalmol. 1999 Nov;128(5):643–4.
Guler M, Yilmaz T, Guler O. A case of ectopic cilia. Int Ophthalmol. 2009 Aug;29(4):297–8.
Sim KT, Sullivan SC. Aberrant lacrimal gland within the tarsal plate presenting as hyperlacrimation. Eye. 1999 Aug;13(4):591–3.
Hase K, Kase S, Noda M, Ohashi T, Shinkuma S, Ishida S, . Ectopic cilia: a histopathological study. Case Rep Dermatol. 2012 Jan;4(1):37–40.
Al-Najmi Y, Abdalla Elsayed M. A rare case report of posterior ectopic cilia in a 41-year-old Saudi male. Case Rep Ophthalmol. 2020 Sep–Dec;11(3):626–9.
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Peramiquel L, Barnadas MA, Dalmau J, Roe E, Alomar A. A case of ectopic cilia. J Eur Acad Dermatol Venereol. 2007 Feb;21(2):250.
Milman T, Jakobiec FA, Lally SE, Shields JA, Shields CL, EagleRCJr, . Lacrimal gland hamartoma (formerly termed dacryoadenoma). Am J Ophthalmol. 2020 Sep;217:189–97.
Pokorny KS, Hyman BM, Jakobiec FA, Perry HD, Caputo AR, Iwamoto T, . Epibulbar choristomas containing lacrimal tissue. Ophthalmology. 1987 Oct;94(10):1249–57.
Shields CL, Alset AE, Boal NS, Casey MG, Knapp AN, Sugarman JA, . Conjunctival tumors in 5002 cases. Comparative analysis of benign versus malignant counterparts the 2016 James D. Allen lecture. Am J Ophthalmol. 2017 Jan;173:106–33.
Hassan WM, Bakry MS, Hassan HM, Alfaar AS. Incidence of orbital, conjunctival and lacrimal gland malignant tumors in USA from surveillance, epidemiology and end results, 1973–2009. Int J Ophthalmol. 2016;9(12):1808–13.
Chen TS, Mathes EF, Gilliam AE. “Ectopic eyelashes” (ectopic cilia) in a 2-year-old girl: brief report and discussion of possible embryologic origin. Pediatr Dermatol. 2007 Jul–Aug;24(4):433–5.
References_xml – reference: Pokorny KS, Hyman BM, Jakobiec FA, Perry HD, Caputo AR, Iwamoto T, . Epibulbar choristomas containing lacrimal tissue. Ophthalmology. 1987 Oct;94(10):1249–57.
– reference: Dinc E, Yildirim O. A rare case of ectopic cilia. Can J Ophthalmol. 2014 Feb;49(1):e8–9.
– reference: Font RL, Ferry AP. The phakomatoses. Int Ophthalmol Clin. 1972;12(1):1–50.
– reference: Shields CL, Alset AE, Boal NS, Casey MG, Knapp AN, Sugarman JA, . Conjunctival tumors in 5002 cases. Comparative analysis of benign versus malignant counterparts the 2016 James D. Allen lecture. Am J Ophthalmol. 2017 Jan;173:106–33.
– reference: Hase K, Kase S, Noda M, Ohashi T, Shinkuma S, Ishida S, . Ectopic cilia: a histopathological study. Case Rep Dermatol. 2012 Jan;4(1):37–40.
– reference: Guler M, Yilmaz T, Guler O. A case of ectopic cilia. Int Ophthalmol. 2009 Aug;29(4):297–8.
– reference: Chen TS, Mathes EF, Gilliam AE. “Ectopic eyelashes” (ectopic cilia) in a 2-year-old girl: brief report and discussion of possible embryologic origin. Pediatr Dermatol. 2007 Jul–Aug;24(4):433–5.
– reference: Roper GJ, Smith MS, Lueder GT. Congenital smooth muscle hamartoma of the conjunctival fornix. Am J Ophthalmol. 1999 Nov;128(5):643–4.
– reference: da Fonseca FL, Yamanaka PK, Lima PP, Matayoshi S. A 6-year-old girl with ectopic cilia and hypochromic nevus. Clin Ophthalmol. 2014;8:1259–61.
– reference: Peramiquel L, Barnadas MA, Dalmau J, Roe E, Alomar A. A case of ectopic cilia. J Eur Acad Dermatol Venereol. 2007 Feb;21(2):250.
– reference: Sim KT, Sullivan SC. Aberrant lacrimal gland within the tarsal plate presenting as hyperlacrimation. Eye. 1999 Aug;13(4):591–3.
– reference: Milman T, Jakobiec FA, Lally SE, Shields JA, Shields CL, EagleRCJr, . Lacrimal gland hamartoma (formerly termed dacryoadenoma). Am J Ophthalmol. 2020 Sep;217:189–97.
– reference: Hassan WM, Bakry MS, Hassan HM, Alfaar AS. Incidence of orbital, conjunctival and lacrimal gland malignant tumors in USA from surveillance, epidemiology and end results, 1973–2009. Int J Ophthalmol. 2016;9(12):1808–13.
– reference: Chan S, Stewart CM. Epibulbar osseous choristoma: a rare find in the superior conjunctival tarsal plate of the upper eyelid. Ophthalmic Plast Reconstr Surg. 2020 Mar/Apr;36(2):e34–6.
– reference: Al-Najmi Y, Abdalla Elsayed M. A rare case report of posterior ectopic cilia in a 41-year-old Saudi male. Case Rep Ophthalmol. 2020 Sep–Dec;11(3):626–9.
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SubjectTerms Biopsy
Case Report
Case reports
choristoma
Exocrine glands
Hair
hamartoma
Histology
Smooth muscle
tarsal choristoma
Tumors
vellus hair
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Title Rare Choristoma of the Tarsal Conjunctiva: Critical Inspection Prevents Unnecessary Mutilation
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