J Korean Ophthalmol Soc.  2017 Aug;58(8):998-1002. 10.3341/jkos.2017.58.8.998.

A Case of Recurrent Myxomatous Corneal Degeneration Treated by Interferon Alpha-2b

• Park YM
• Ahn M
• Kang WS
• You IC

• KMID: 2388191
• DOI: http://doi.org/10.3341/jkos.2017.58.8.998

Abstract

PURPOSE
To report a case of recurrent myxomatous corneal degeneration after pterygectomy.
CASE SUMMARY
A 65-year-old man with a history of abdominal keloid was referred to our hospital for assessment of a well-circumscribed, gelatinous, whitish corneal mass on the nasal corneal area of the left eye that appeared one month prior. The patient had undergone pterygectomy on his left eye 2 years ago. The patient experienced mild foreign body sensation. The other anterior segment and fundus examination of the left eye were both normal. We diagnosed the case as keloid and we performed excisional biopsy of the corneal mass. Histologic findings revealed proliferation of myxoid-appearing material in the anterior corneal stroma. On immunohistochemical examination, sections were stained positive for actin and calretinin, and negative for S-100. We diagnosed the tumor as myxomatous corneal degeneration. After six months, a recurrent mass was found on the previously excised site. Re-excisional biopsy and topical interferon α-2b treatment were then performed in response. After re-excision, there was no recurrence or complications during one year follow-up.
CONCLUSIONS
Myxomatous corneal degeneration should be considered during differential diagnosis of an elevated, whitish, gelatinous lesion of the cornea with previous history of trauma or operation, such as pterygectomy. An interferon α-2b topical treatment is useful for recurrent corneal myomatous degeneration.

Keyword

Corneal mass; Interferon α-2b; Myxomatous corneal degeneration; Pterygectomy

MeSH Terms

Actins
Aged
Biopsy
Calbindin 2
Cornea
Corneal Stroma
Diagnosis, Differential
Follow-Up Studies
Foreign Bodies
Gelatin
Humans
Interferons*
Keloid
Recurrence
Sensation
Actins
Gelatin
Interferons

Figure

• 

  Figure 1 Slit-lamp findings of corneal mass from the left eye of a 65-year-old man. (A) At the first visit, well circumscribed whitish, movable, and partially transparent corneal mass on the nasal corneal area. (B) Mass was removed well on the cornea by excision.

• 

  Figure 2 Immunohistochemical staining on permanent paraffin slides of corneal mass. (A) Spindle cell proliferation with reticular fiber in prominent hypovascular myxoid stroma (H&E, ×400) (arrows), Scale bar, 20 µm. (B) Positive for actin stain, ×200 (arrows), Scale bar, 20 µm. (C) Positive for calretinin stain, ×200 (arrows), Scale bar, 20 µm. (D) Negative for S-100 stain, ×200, Scale bar, 20 µm.

• 

  Figure 3 Anterior segment photography of recurrence 6 months after excision. (A) Recurrent corneal mass on the same site. (B) Note the clear cornea without recurrence or complication at 12 months after re-excision.

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