Clinical Features of Conjunctival Dermolipoma

Hee Jun Song; Ho Sik Hwang; Yoon Yang Jung; Ji Won Kwon

doi:10.3341/jkos.2018.59.12.1108

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Song, Hwang, Jung, and Kwon: Clinical Features of Conjunctival Dermolipoma

Original Article

J Korean Ophthalmol Soc 2018;59(12):1108-1113.

Published online: 25 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.12.1108

Clinical Features of Conjunctival Dermolipoma

Hee Jun Song, MD¹, Ho Sik Hwang, MD, PhD², Yoon Yang Jung, MD, PhD³, Ji Won Kwon, MD, PhD^1,

¹Department of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea

²Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea

³Department of Pathology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea

Address reprint requests to Ji Won Kwon, MD, PhD Department of Ophthalmology, Myongji Hospital, #55 Hwasu-ro 14bun-gil, Deokyang-gu, Goyang 10475, Korea Tel: 82-31-810-6250, Fax: 82-31-810-0500 E-mail: eyeminerva@naver.com

Received 28 June 2018 Revised 20 August 2018 Accepted 27 November 2018

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 evaluate the clinical features of conjunctival dermolipoma.

Methods

We reviewed the ocular records of 18 consecutive patients diagnosed with dermolipoma in our hospital between March 2016 and March 2018.

Results

The study population consisted of eight females and 10 males with a mean age of 61 months (range 3 months to 45 years old), with a pinkish conjunctival mass located at a mean of 4.7 mm (range 2–8 mm) from the temporal limbus and anterior to the lateral orbital rim. The mean visual acuity of eight patients in whom it was possible to measure visual acuity was 0.9 (range 0.6–1.0). Surgery was performed in two eyes. Pathological examination revealed conjunctival dermolipoma. Postoperatively, there was no evidence of visual changes or specific complications.

Conclusions

Conjunctival dermolipoma may be suspected in cases with a congenital subconjunctival non-movable mass, which can be confirmed by computed tomography and pathological examination.

Keywords: Conjunctival dermolipoma, Orbital fat prolapse

References

1. Mansour AM, Barber JC, Reinecke RD, Wang FM. Ocular choristomas. Surv Opthalmol. 1989; 33:339–58.

2. Cho BJ, Han YK, Hyon JY, et al. Two cases of cosmetic treatment of limbal dermoid. J Korean Ophthalmol Soc. 2001; 48:1419–24.

3. Spencer WH. Ophthalmic pathology: an atlas and textbook. 4th ed.Vol. 4. Philadelphia: W.B.Saunders;1996. p. 50.

4. Shields JA, Augsburger JJ, Donoso LA. Orbital dermoid cyst of conjunctival origin. Am J Ophthalmol. 1986; 101:726–9.

5. Lee SH, Kim KH, Kim SY. A case of conjunctival dermoid cyst of the orbit. J Korean Ophthalmol Soc. 2010; 51:601–5.

6. Shields JA, Kaden IH, Eagle RC Jr, Shields CL. Orbital dermoid cysts: clinicopathologic correlations, classification, and management. The 1997 Josephine E. Schueler Lecture. Ophthal Plast Reconstr Surg. 1997; 13:265–76.

7. Kim YD, Robert AG. Orbital fat prolapse and dermolipoma: two distinct entities. Korean J Ophthalmol. 1994; 8:42–3.

8. Kim E, Kim HJ, Kim YD, et al. Subconjunctival fat prolapse and dermolipoma of the orbit: Differentiation on CT and MR imaging. AJNR Am J Neuroradiol. 2011; 32:465–7.

9. Yoon CK, Kim JH, Kim SJ, Yu YS. The surgical outcomes of simple keratectomy for limbal dermoids. J Korean Ophthalmol Soc. 2008; 49:897–903.

10. Jeong J, Song YJ, Jung SI, Kwon JW. New surgical approach for limbal dermoids in children: simple excision, corneal tattooing and sutureless limboconjunctival autograft. Cornea. 2015; 34:720–3.

11. Zloto O, Rosner M. An unusual presentation of conjunctival dermolipoma with a skin tag. J Carniofac Surg. 2018; 29:e302–3.

12. Nevares RL, Mulliken JB, Robb RM. Ocular dermoids. Plast Reconstr Surg. 1988; 82:959–64.

13. Sa HS, Kim HK, Shin JA, et al. Dermolipoma surgery with rotational conjunctival flaps. Acta Ophthalmol. 2012; 90:86–90.

14. Choi YJ, Kim IH, Choi JH, et al. Early results of surgical management of conjunctival dermolipoma: partial excision and free conjunctival autograft. Br J Ophthalmol. 2015; 99:1031–6.

15. Glover AT, Grove AS Jr. Subconjunctival orbital fat prolapse. Ophthalmic Plast Reconstr Surg. 1987; 3:83–6.

Figure 1.

Pre and Postoperative slit lamp photographs (A, D), preoperative orbital computed tomography (CT) (B) and histopathologic photographs (C) of the conjunctival mass in the left eye in 5-year-old boy. (A) At initial presentation, there is a dermolipoma in the temporal bulbar conjunctiva. (B) Preoperative orbital CT shows crescent-shaped fatty mass at the superotemporal aspect of the right epibulbar area, which abuts the lateral wall of the eyeball, anterior to the insertion of the lateral rectus muscle and medial to the lacrimal gland (arrow). (C) Histological examination shows abundant adipose tissue with collagenous bundles (hematoxylin and eosin [H&E] stain, ×200). (D) 1 month after surgery, there was clear excision site only with very slight conjunctival injection. A good cosmesis was achieved.

Figure 2.

Pre and postoperative slit lamp photographs (A, D), preoperative orbital computed tomography (CT) (B) and histopathologic photographs (C) of conjunctival mass in the left eye in 45-year-old man. (A) Temporal conjunctival mass in the superotemporal area is shown. (B) Preoperative orbital CT shows crescent-shaped fatty mass from lateral conjunctiva to the area of lateral rectus muscle (arrow). (C) Histological examination reveals abundant adipose tissue and collagen bundles (hematoxylin and eosin [H&E] stain, ×200). (D) 1 week after surgery, slight subconjunctival hemorrhage and injection were shown.

Figure 3.

A slit lamp photograph of 75-year-old women presented with a 1-year history of progressive swelling over the left eye. She had no other clinically significant medical history or trauma. There was a soft, yellowish mass in the outer temporal subconjunctival region.

Table 1.

Dermographics and clinical characteristics of 18 patients who were clinically diagnosed with conjunctival dermolipoma

Case No.	Age	Gender	Associated abnormality	Involved eye	VA (decimal)	Distance from limbus (mm)	Operation	Postoperative complications
1	4 M	F	Goldenhar	Left	NA	NA	None	–
2	6 M	F	None	Left	NA	NA	None	–
3	3 M	M	None	Left	NA	NA	None	–
4	4 M	M	None	Left	NA	NA	None	–
5	2 Y	M	None	Right	NA	5	None	–
6	2 M	M	None	Right	NA	NA	None	–
7	5 Y	M	None	Left	1.0	4	Done	None
8	4 M	F	None	Right	NA	NA	None	–
9	5 Y	F	None	Right	1.0	4	None	–
10	45 Y	M	None	Left	1.0	3	Done	None
11	6 Y	F	None	Left	1.0	8	None	–
12	5 Y	M	None	Right	1.0	2	None	–
13	7 Y	F	None	Right	1.0	5	None	–
14	4 Y	M	None	Right	0.6	7	None	–
15	5 M	F	None	Left	NA	NA	None	–
16	10 M	F	None	Left	NA	NA	None	–
17	10 Y	M	None	Right	1.0	5	None	–
18	7 M	M	None	Left	NA	NA	None	–

VA = visual acuity (corrected); M = month; Y = year; F = female; NA = not applicable; M = male.

Table 2.

Comparison between orbital fat prolapse and conjunctival dermolipoma

	Orbital fat prolapse	Dermolipoma
Origin	Acquired	Congenital
Cause	Herniation of orbital fat	Congenital mass
Contents	Fat	Fat, hair, dermal appendage
Color	Yellow	Pinkish-white, pinkish-yellow
Features	Soft, mobile	Soft, non-mobile
Indentation	Yes	No
CT findings	Radiolucent mass continuous with orbital fat	Radiolucent mass of fat in the area of external rectus muscle

CT = computed tomography.

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