Case Report of Nodular Fasciitis in the Conjunctiva

Jin-ho Kim; Kyung Sun Na; Chang-hyun Park; Seung Jin Lee; Tae Hoon Oh; Hyun Seung Kim

doi:10.3341/jkos.2020.61.3.303

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Kim, Na, Park, Lee, Oh, and Kim: Case Report of Nodular Fasciitis in the Conjunctiva

Case Report

J Korean Ophthalmol Soc 2020;61(3):303-306.

Published online: 25 September 2020

DOI: https://doi.org/10.3341/jkos.2020.61.3.303

Case Report of Nodular Fasciitis in the Conjunctiva

Jin-ho Kim, MD¹, Kyung Sun Na, MD, PhD¹, Chang-hyun Park, MD¹, Seung Jin Lee, MD², Tae Hoon Oh, MD², Hyun Seung Kim, MD, PhD¹

¹Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea

²Jalbonun St. Mary's Eye Clinic, Seoul, Korea

Address reprint requests to Hyun Seung Kim, MD, PhD Department of Ophthalmology, College of Medicine, The Catholic University of Korea, #222 Banpo-daero, Seocho-gu, Seoul 06591, Korea Tel: 82-2-2258-1188, Fax: 82-2-599-7405 E-mail: sara514@catholic.ac.kr

Received 4 April 2019 Revised 9 September 2019 Accepted 21 February 2020

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

We report a case of nodular fasciitis of the conjunctiva that has not been previously reported in the Republic of Korea.

Case summary

A 18-year-old female patient presented with a left conjunctival mass, which had been enlarging for 1 month. The tumor was located at the corner of the conjunctiva of the left eye. The size of the tumor was 1 mm in width and 1.5 mm in height, and tenderness and redness were not observed. There was no history of trauma, but bilateral upper lid blepharoplasty was performed 2 months prior to her visit. Excision of a conjunctival mass was performed and there was no evidence of involvement of the sclera or peripheral conjunctiva around the mass. We performed immunohistochemistry and PCR for human herpes virus 8 (HHV8). Immunohistochemistry was positive for S-100 and negative for smooth muscle actin and HHV8. The mass was myofi-broblastic in nature and the histopathological features and clinical findings of this case were diagnosed as nodular fasciitis with the features as described above. There was no recurrence for 4 months after removal of the mass.

Conclusions

Because the treatments and prognoses of malignant tumors or other inflammatory diseases such as nodular scleritis and nodular fasciitis are quite different, differentiation from these diseases is considered an important factor in the diagnosis of nodular fasciitis.

Keywords: Conjunctival mass, Conjunctival neoplasms, Nodular fasciitis

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Figure 1.

Preoperative and postoperative appearance of conjunctival mass. (A) Preoperative appearance showing 1 × 1.5 mm sized, movable, nontender, well circumscribed mass at nasal side of conjunctiva on slit-lamp examination. (B) Postoperative appearance of the next day after excision of the conjunctival mass on slit-lamp examination. Well approximated excision suture site was shown.

Figure 2.

Histopathology from the excised mass. Photomicrograph showing randomly distributed fascicles of immature and uniform fibroblastic cells (hematoxylin and eosin staining, ×100).

Figure 3.

Immunohistochemical test of the excised mass. (A) Spindle-shaped fibroblasts in nodular fasciitis were shown to be negative for of S-100 (×40), (B) Spindle-shaped fibroblasts in nodular fasciitis were shown to be positive for of smooth muscle actin (×40).

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