J Korean Ophthalmol Soc.  2020 Mar;61(3):303-306. 10.3341/jkos.2020.61.3.303.

Case Report of Nodular Fasciitis in the Conjunctiva

• Kim JH
• Na KS
• Park CH
• Lee SJ
• Oh TH
• Kim HS

• KMID: 2471773
• DOI: http://doi.org/10.3341/jkos.2020.61.3.303

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 myofibroblastic 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.

Keyword

Conjunctival mass; Conjunctival neoplasms; Nodular fasciitis

MeSH Terms

Actins
Adolescent
Blepharoplasty
Conjunctiva*
Conjunctival Neoplasms
Diagnosis
Fasciitis*
Female
Humans
Immunohistochemistry
Muscle, Smooth
Myofibroblasts
Polymerase Chain Reaction
Prognosis
Recurrence
Republic of Korea
Sclera
Scleritis
Actins

Figure

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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).

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  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).

Reference

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