A Case of Bilateral Conjunctival Amyloidosis Treated with Mass Excision and Cryotherapy

Boyun Kim; Ji Hye Song; Suk-Woo Yang; Man Soo Kim

doi:10.3341/jkos.2011.52.5.628

Journal List > J Korean Ophthalmol Soc > v.52(5) > 1009046

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Kim, Song, Yang, and Kim: A Case of Bilateral Conjunctival Amyloidosis Treated with Mass Excision and Cryotherapy

Original Article

J Korean Ophthalmol Soc 2011;52(5):628-632.

Published online: 3 August 2011

DOI: https://doi.org/10.3341/jkos.2011.52.5.628

A Case of Bilateral Conjunctival Amyloidosis Treated with Mass Excision and Cryotherapy

Boyun Kim, MD, Ji Hye Song, MD, Suk-Woo Yang, MD, Man Soo Kim, MD

Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea

Address reprint requests to Man Soo Kim, MD Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital #505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea Tel: 82-2-2258-1188, Fax: 82-2-590-7405, E-mail: mskim@catholic.ac.kr

Received 27 August 201017 November 2010 Accepted 21 February 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the treatment results of mass excision and cryotherapy in a case of bilateral conjunctival amyloidosis.

Case summary

A 72-year-old man with conjunctival mass and foreign body sensations in both eyes visited our clinic. He was previously diagnosed with conjunctival lymphoma after conjunctival biopsy at another hospital. A yellow-pink colored mass was observed in the bulbar conjunctiva. A repeated conjunctival biopsy revealed the mass to be amyloid, consistent with the cervical lymph node biopsy results, and the diagnosis was changed to primary systemic amyloidosis. The patient was treated with melphalan and prednisolone; however, the ocular pain, symblepharon, and conjunctival mass progressed. A 360 degree conjunctivoperiotomy, mass excision, and repeated cryotherapy were performed in the more severely affected left eye. The patient was followed for one year, and there were no complications or progression of the conjunctival lesion.

Conclusions

Conjunctival amyloidosis requires local pathologic confirmation as well as a systemic work-up. If surgical removal is necessary despite systemic treatment, mass excision and cryotherapy may be effective.

Keywords: Congo-red, Conjunctival amyloidosis, Cryotherapy

References

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Figure 1.

A 4×3 mm sized yellow mass (A) (arrow) is seen in the inferomedial conjunctiva in the right eye. A 6×5 mm sized yel-low-pinkish mass (B) (arrow) is seen in the inferomedial conjunctiva in the left eye. The mass was larger and more severe in the left eye.

Figure 2.

Depositions of amorphous, homogenous eosinophilic material (arrow) are seen in the conjunctiva. The black arrow indicates eosinophilic material (A) (H&E staining, ×100). Dichroism and birefringence are seen (B) (Congo-red staining, polarizing filter, ×400).

Figure 3.

External findings of left eye before mass excision (A) and after treatment with cryotherapy and mass excision (B).

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