Lacrimal Gland Choristoma Research Articles

Cancer and the eye: giant steps forward. The Cambridge Symposium 2012

Cancer and the eye: giant steps forward. The Cambridge Symposium 2012

Resection of Intraocular Tumors (Partial Lamellar Sclerouvectomy) in the Pediatric Age Group

To describe the outcome of intraocular tumor resection by partial lamellar sclerouvectomy (PLSU) in the pediatric age group. Retrospective, interventional case series. We included 37 patients who underwent PLSU for intraocular tumors under age 21 years. Medical records were reviewed for clinical, operative, and histopathologic features. Globe salvage, visual acuity, surgical side effects, tumor control, and tumor-related metastasis and death. The mean patient age was 9 years (median, 10; range, 0.25-17) and there were 22 (59%) females and 15 (41%) males. The tumor involved mainly the iris (n = 27; 73%), ciliary body (n = 7; 19%), or choroid (n = 3; 8%). The mean tumor basal dimension was 7 mm (median, 6; range, 3-15) and thickness was 3.6 mm (median, 3; range, 0.2-9.6). The histopathologic diagnosis was melanoma (n = 19; 51%), cyst (n = 5; 14%), medulloepithelioma (n = 4; 10%), melanocytoma (n = 3; 8%), lacrimal gland choristoma (n = 2; 5%), gliosis (n = 1; 3%), nevus (n = 1; 3%), hemorrhage (n = 1; 3%), and leiomyoma (n = 1; 3%). Intraoperative adverse effects included vitreous loss in 19 (51%) and hyphema in 4 (11%). Postoperative side effects included early transient hyphema in 9 (24%) and late cataract in 12 (32%). Local tumor recurrence was detected in 5 cases (13%) at mean interval of 28 months, including melanoma (n = 3) and medulloepithelioma (n = 2). Enucleation was necessary in 9 (24%) cases for recurrence in 3 (8%), prophylactic in eyes with high-grade malignancy in 5 (13%), and for blind painful eye in 1 (3%). Of the 28 salvaged eyes, final visual acuity was ≥ 20/40 in 18 (64%), 20/50 to 20/100 in 5 (18%), and <20/200 in 5 (18%). There were no cases of metastasis or death at a mean of 51 months of follow-up. A surgically challenging procedure, PLSU can achieve control of selected intraocular tumors. Medulloepithelioma responds poorly to local resection and in most cases enucleation is required. If the globe is salvaged, visual acuity is ≥ 20/40 in 64% of children. The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Solitary Lacrimal Gland Choristoma of the Limbal Conjunctiva

Lacrimal gland choristoma occurs in cases with a failure in migration of any portion of the lacrimal secretory apparatus. It is a rare conjunctival tumor. The authors report the clinical and histopathologic features of a conjunctival lacrimal gland choristoma. A 34-year-old woman presented with a pinkish conjunctival mass in the left eye that had been present since birth. The lesion was removed by excisional biopsy and the histopathologic findings were consistent with conjunctival lacrimal gland choristoma. Clinically, these tumors resemble conjunctival hemangioblastoma, lymphangioma, or a lymphoid infiltrate. Its presence since birth, temporal epibulbar location, and pink solid appearance can help in the differential diagnosis.

Lacrimal gland choristoma in a preterm infant, presenting with spontaneous hyphema and increased intraocular pressure

We report a case of intraocular lacrimal gland choristoma presenting very early in a preterm infant with hyphema, a mass lesion and raised intraocular pressure. Enucleation of the involved eye, which is the treatment in most cases, was performed and prosthesis was fitted successfully. An interesting additional finding in our patient was a choroidal defect, not reported to date with other cases in the literature.

Intraocular Lacrimal Gland Choristoma Diagnosed by Fine-Needle Aspiration Biopsy

To describe an intraocular lacrimal gland choristoma confirmed with fine-needle aspiration biopsy in a child. Case report. A 6-year-old Asian girl developed a pink, vascularized, cerebriform mass with marked corectopia in the inferonasal iris of the left eye. The differential diagnosis included juvenile xanthogranuloma, nevus, melanoma, medulloepithelioma, lacrimal gland choristoma, and atypical retinoblastoma. Fluorescein angiography was suggestive of a noninflammatory, nonleaking solid mass. Fine-needle aspiration biopsy showed benign epithelial cells consistent with lacrimal tissue. Lacrimal gland choristoma shows notable clinical features and fine-needle aspiration biopsy can be confirmatory.

Lacrimal Gland Choristoma of the Ciliary Body

Lacrimal gland choristoma manifesting in the ciliary body is quite rare. We report a case of lacrimal gland choristoma manifesting in the ciliary body, coupled with orbital cellulites, in an infant. A 10-month-old female infant with swelling and tenderness of the right upper eyelid. The results of ophthalmic examinations of the patient were consistent with orbital cellulitis. During the funduscopic examination, a fleshy mass was incidentally detected at the superotemporal portion of the ciliary body in the right eye. A local resection of the lesion was carried out. The results of a pathologic examination showed lacrimal gland choristoma of the ciliary body that was accompanied by an epithelia-lined cyst. The patient has had no hypotonia or enlargement of the lesion for 1 year after surgery. Lacrimal gland choristoma should be included in the differential diagnosis of a ciliary body mass in pediatric patients.

Intraocular lacrimal gland choristoma involving iris and ciliary body

PURPOSE: To describe clinical and pathologic features of an iridociliary lacrimal gland choristoma in which the diagnosis was made clinically and confirmed histopathologically. METHODS: Case report with clinical, ultrasound biomicroscopic, and histopathologic observations. RESULTS: We examined a 12-month-old male for a large iris mass that had been present since birth. We suspected it to be a lacrimal gland choristoma based on characteristic clinical features. The lesion was removed by iridocyclectomy, and the diagnosis of lacrimal gland choristoma was confirmed. CONCLUSION: Intraocular lacrimal gland choristoma has unique clinical features that should suggest the diagnosis.

Iris cysts in children: classification, incidence, and management

BACKGROUNDIris cysts in children are uncommon and there is relatively little information on their classification, incidence, and management.METHODSThe records of all children under age 20 years who were diagnosed with...

Natural Course and Histopathologic Findings of Lacrimal Gland Choristoma of the Iris and Ciliary Body

To show a well-documented clinicopathologic correlation of lacrimal gland choristoma of the iris and ciliary body, to review the literature on the subject, and to recommend treatment of this condition. A congenital iridociliary mass was removed by iridocyclectomy when a female infant was 19 months old because it had produced a large cyst, secondary glaucoma, a vascularized corneal pannus, focal cataract, and iris heterochromia secondary to pigment dispersion. The excised mass was studied by routine histopathologic methods. The mass proved histopathologically to be a lacrimal gland choristoma composed of mature lacrimal gland tissue associated with a large epithelial-lined cyst and several smaller cysts. Postoperatively, the glaucoma resolved and the child had visual acuity of 20/40 14 months after surgery. Lacrimal gland choristoma of the anterior uvea has typical clinical features that should indicate that correct diagnosis. It is a fleshy, often cystic, lesion with an irregular, cerebriform surface that appears identical to the lacrimal gland in the orbit. Although the mass itself is generally stable, secondary cysts in the lesion can enlarge and secondary glaucoma and other complications can develop. Consequently, affected patients should be followed up at close intervals and surgical excision performed if such complications begin to develop.

Intraocular lacrimal gland choristoma

There have been nine previously reported cases of intraocular lacrimal gland choristoma. This case report is of an infant with an intraocular lacrimal gland choristoma which was managed conservatively for a 19-month period until the onset of glaucoma. Tumour biopsy was initially performed because until this time the tumour's behaviour suggested it was not malignant. The latter was confirmed on biopsy, however hypotony resulted following the surgical intervention.

Lacrimal Gland Choristoma of the Ciliary Body

A 22-month-old girl was found to have a pigmented mass of the ciliary body of the right eye. Five months later the globe was enucleated because of enlargement of the tumor and the appearance of brown pigment on the adjacent epibulbar surface. Histopathologic examination disclosed a lacrimal gland choristoma of the ciliary body with involvement of the limbal conjunctival surface and superficial sclera. Choristomas of the lacrimal gland are rare and only eight cases have been reported previously to occur intraocularly. Most of these cases showed extrascleral involvement which suggests that the anlage for these choristomas may be entrapped intraocularly during the development of the globe. We recommend conservative management, either by observation or local resection if possible.