Journal List > J Korean Ophthalmol Soc > v.49(12) > 1008170

Kim, Chun, and Kim: A Case of Limbal Pseudotumor

Abstract

Purpose

To report a rare case of localized orbital pseudotumor in the limbus.

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.

Conclusions

The authors reported the first case of localized orbital pseudotumor in the limbus. Anterior segment fluorescein angiography was found useful in the evaluation and differential diagnosis of this type of limbal mass.

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Figure 1.
The anterior segment photograph shows a circumferentially protruded gelatinous limbal mass (4-8 o’clock) and engorged conjunctival vessels on the left eye at the first visit (A). At two-month, the left conjunctival mass engorged with prominent vasculature (B). At four-month, the mass becomes wider and also shows some paleness (C) with well demarcated mass margin under the blue light (D).
jkos-49-2011f1.tif
Figure 2.
Anterior segment fluorescein angiograms show an interrupted fluorescence at the area of infiltrative mass at eight seconds (A), and a relative hypofluorescence at thirty seconds (B).
jkos-49-2011f2.tif
Figure 3.
Microscopic examination of limbal mass shows severe chronic nonspecific inflammation (A: H&E stain, ×40). There is marked infiltration of lymphocytes (arrow), plasma cells (white arrow) and neutrophils (arrow head) (B: H&E stain, ×400)
jkos-49-2011f3.tif
Figure 4.
Anterior segment photograph shows no evidence of recurrence and complication on the limbus at postoperative six-month.
jkos-49-2011f4.tif
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