|Year : 1962 | Volume
| Issue : 1 | Page : 24-26
A case of bilateral dermolipoma
KN Mathur, Usha Kehar, PN Wahi, TP Agarwal
Departments of Ophthalmology and Pathology, S. N. Medical College, Agra, India
|Date of Web Publication||18-Mar-2008|
K N Mathur
Departments of Ophthalmology and Pathology, S. N. Medical College, Agra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mathur K N, Kehar U, Wahi P N, Agarwal T P. A case of bilateral dermolipoma. Indian J Ophthalmol 1962;10:24-6
Dermolipoma is a congenital lesion which occurs in and under the bulbar conjunctiva, usually towards the lateral canthus, between the superior and lateral rectus muscles. Rarely it may be symmetrical in both the eyes (Novak, 1920 Kranz, 1927). It may be multiple (Wagenmann, 1910) or may be seen at the inner angle in association with the plica-semilunaris (Duysl, 1898) or caruncle (Bock, 1886). As the bilateral Dermolipoma is very uncommon, a single case report is justified.
| Case Report|| |
Patient named O.W., aged 15 years, Hindu female was admitted in this hospital on March 17, 1960 with the complaints of gradually increasing swelling in both eyes towards lateral canthi, more marked in the left eye than in the right, for the last six years. On systemic examination there was no other abnormality in the body.
As seen in [Figure - 1], the tumour was situated in the lateral canthus on either side, the superior, inferior and lateral limits of which could not be reached, while medially it is about 1 cm. from the limbus in the left eye and 1.5 cm. in the right eye. [Figure - 2] shows the prominence of the tumour on convergence of the eye. It is soft in consistency, with diffuse margins and yellowish in colour. It is mobile underneath the conjunctiva and not fixed to the deeper structures. On the surface, there is a localised area of keratinization with the presence of small hair which could be seen only with the binocular loupe. The keratinized area is more marked in the left eye than in the right. No other abnormality could be found in the eyes.
The growth was excised under local anaesthesia. [Figure - 3] shows the condition of the eye three months after the operation.
The growths consisted of two irregular pieces of tissue measuring 1 x 0.8 x 0.4 cm. (right eye) and 2.2 x 1.4 x 4 cms. (left eye). The margins are irregular and the growths do not appear to be encapsulated. The cut surface is smooth and yellowish. The consistency is soft.
Histopathological examination showed the typical picture of dermolipoma in the tissue removed from both the eyes. The most superficial area showed the presence of keratinized epithelium with the sub-epithelial zone showing masses of fat cells intermixed with bands of connective tissue as seen in [Figure - 4]. [Figure - 5] shows a higher magnification of the lipomatous tissue intermixed with bands of sub-epithelial connective tissue.
| Comment|| |
These tumours were originally described as lipoma (Kranka, 1884) and are essentially fibro-fatty in nature, but although a pure lipoma may occur the majority of such growths are of dermoid nature. It is a congenital lesion occurring in and under the bulbar conjunctiva, commonly towards the lateral canthi between the superior and lateral recti muscles, but rarely may be multiple or symmetrical in both the eyes or may be in association with plica-semilunaris or caruncle. It is covered by a thick epidermal epithelium, in which there may be hair or evidences of glandular appendages with the secretions. The tumour is a harmless one and shows no tendency to progress. Its importance lies only in the fact that it may be a cosmetic blemish. Sometimes because of the presence of hair and keratinization there may be some signs of irritation.
Whenever the growth is present, it should be excised with the keratinized epidermis. Swann, Emmens and Christensen (1948) point out that the excision of the Dermolipoma may require such an extensive dissection that the conjunctiva may become adherent to the globe and thus restrict the movements of the eye and the movements of the lids. They feel that a diplopia with even some distortion of the lid may be produced. Thus they stress the importance of placing some of the Tenon's capsule or transplantation of the underlying areolar tissue as they afford greater mobility to the conjunctiva.
The serial sections of the growth usually reveal the presence of cutaneous elements such as hair follicles or sebaceous glands as well as smooth and striped muscle fibres and lacrimal glandular acini.
| Summary|| |
A case of bilaterally symmetrical Dermolipoma is being reported, in which the growth was excised under local anaesthesia without any restriction in the movements of the eye and of the lids.
| References|| |
Bock, (1886), Klin. Monats, 24, 487.
Duke-Elder, W. S., "Text book of Ophthalmology", (1940), Henry Kimpton, London, (St. Louis Mosby), V. 2, p. 1409.
Ingalls, R. G.: "Tumours of the Orbit and allied tumours", (1953), Charles C, Thomas, P. 310.
Kranka, (1854) , Annal d' Oc. , 31, 105.
Krauz, (1927), Arch. f. Ophthal. 118, 167.
Novak, (1920), Klin, Monats. 65, 424.
Reese, A, B.: "Tumours of the eye", (1951), Paul B. Hoebu, Inc., p. 494.
Swann, K. C., Emmens, T. H. and Christensen, L.: (1948), Tr. Am. Acad. Ophth., 458-469.
Wagenmann, (1927), Arch. f. Ophthal. 74, 489.
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5]