Abstract
Case summary
A 60-year-old man with a limbal mass in the left eye was referred to our clinic for further treatment. The patient’s symptoms began 9-months earlier, and he was treated with oral prednisolone, but his symptoms relapsed. His left eye had a circumferentially protruded gelatinous limbal mass. The anterior segment fluorescein angiography was performed and the mass was then surgically removed. There was an interrupted fluorescence at the area of infiltrative mass at 8 seconds, and a relative hypofluorescence at 30 seconds on anterior segment fluorescein angiography. Histologic examination revealed a non-specific inflammatory reaction without the presence of tumor cells and these findings indicated a presumptive diagnosis of limbal pseudotumor. After the cessation of steroid treatment there was no evidence of tumor recurrence at the 6-month follow-up.
References
1. Yuen SJ, Rubin PA. Idiopathic orbital inflammation: ocular mechanisms and clinicopathology. Ophthalmol Clin North Am. 2002; 15:121–6.
3. Kline LB, Hoyt WF. The Tolosa-Hunt syndrome. J Neurol Neurosurg Psychiatry. 2001; 71:577–82.
4. Mombaerts I, Goldschmeding R, Schlingemann RO, Koornneef L. What is orbital pseudotumor? Surv Ophthalmol. 1996; 41:66–78.
5. Kennerdell JS. Management of nonspecific inflammatory and lymphoid orbital lesions. Int Ophthalmol Clin. 1991; 31:7–15.
6. Henderson JW. Orbital tumors, 3rd ed. New York: Raven,. 1994; 391–411.
7. Rootman J, Nugent R. The classification and management of acute orbital pseudotumors. Ophthalmology. 1982; 89:1040–8.
8. Bertelsen TI. Acute sclerotenonitis and ocular myositis complicated by papillitis, retinal detatchment, and glaucoma. Acta Ophthamol. 1960; 38:136–52.
9. Saroglu M, Aktas M, Olgun D, Arun SS. Limbal pseudotumor in a Cob Pony. Vet Ophthalmol. 2005; 8:135–8.
10. Erie JC, Campbell RJ, Liesegang TJ. Conjunctival and corneal intraepithelial and invasive neoplasia. Ophthalmology. 1986; 93:176–83.
11. Sigelman J, Jakobiec FA. Lymphoid lesions of the conjunctiva: relation of histopathology to clinical outcome. Ophthalmology. 1978; 85:818–43.
12. Lass JH, Jenson AB, Papale JJ, Albert DM. Papillomavirus in human conjunctival papillomas. Am J Ophthalmol. 1983; 95:364–8.
13. Sjö NC, Heegaard S, Prause JU. . Human papillomavirus in conjunctival papilloma. Br J Ophthalmol. 2001; 85:785–7.
14. Mattos J, Contreras F, O'Donnell FE Jr. Ring dermoid syndrome. A new syndrome of autosomal dominantly inherited, bilateral, annular limbal dermoids with corneal and conjunctival extension. Arch Ophthalmol. 1980; 98:1059–61.
15. Mauriello JA, Flanagan JC. Pseudotumor and lymphoid tumor: distinct clinicopathologic entities. Surv Ophthalmol. 1989; 34:142–8.
16. Jakobiec FA. Non-infectious orbital inflammations. Spencer WH, editor. Ophthalomic Pathology: An Atlas and Textbook. 4th. Philadelphia: WB Saunders;1996. v. 4. chap. 12.
17. Mombaerts I, Schlingemann RO, Goldschmeding R, Koornneef L. Are systemic corticorsteroids useful in the management of orbital pseudotumor? Ophthalmology. 1996; 103:521–8.
18. Chan TK, Rosenbaum AL, Rao R. . Indocyanine green angiography of the anterior segment in patients undergoing strabismus surgery. Br J Ophthalmol. 2001; 85:214–8.
19. Alsagoff Z, Chew PT, Chee CK. . Indocyanine green anterior segment angiography for studying conjunctival vascular changes after trabeculectomy. Clin Experiment Ophthalmol. 2001; 29:22–6.
20. Parodi MB, Bondel E, Saviano S, Ravalico G. Iris indocyanine green angiography in pseudoexfoliation syndrome and capsular glaucoma. Acta Ophthalmol Scand. 2000; 78:437–42.
21. Watson PG, Bovey E. Anterior segment fluorescein angiography in the diagnosis of scleral inflammation. Ophthalmology. 1985; 92:1–11.
22. Song YS, Lee JK, Kim JC. Circulating endothelial progenitor cells and vasculogenic factors in pterygium pathogenesis. J Korean Ophthalmol Soc. 2006; 47:1472–80.
23. Tayanc E, Akova Y, Yilmaz G, Aydin P. Anterior segment indocyanine green angiography in pterygium surgery with conjunctival autograft transplantation. Am J Ophthalmol. 2003; 135:71–5.