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| CASE REPORT |
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| Year : 1983 | Volume
: 31
| Issue : 1 | Page : 31-32 |
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Granuloma pyogenicum of limbus
Dhan Krishna Sen
Department of Ophthalmology, Maulana Azad Medical College, New Delhi, India
Correspondence Address:
Dhan Krishna Sen
Associate Professor, Guru Nanak Eye Centre, New Delhi-110 002
India
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 6629449 
How to cite this article:
Sen DK. Granuloma pyogenicum of limbus. Indian J Ophthalmol 1983;31:31-2 |
Granuloma pyogenicum (Telangiectatic granulotna) is a dermatological disorder that involves the skin and mucous membrane. It may occur anywhere in the body but its occurence in ocular tissees has rarely been encountered. The condition is known for its recurrence after surgical excision.[1],[2] The case reported here is of interest because of the rarity of the condition and the fact that the lesion did not recur after the surgical excision.
| Case report | |  |
A 60-year-old man reported with a painless growth on the white of the right eye. The growth approximately seven months earlier and had since been steadily growing. The patient was quite certain that no abnormality existed previously at the site of the lesion. There was also no antecedent traumatic or inflammatory episode at the local site.
His uncorrected vision was 6/12 in the right eye and 6/9 in the left eye, which improved to 6/6 in both the eyes with corrective glasses. Left eye : There was a small retention cyst on the medial aspect of lower lid close to its margin. The eye and the adnexa were otherwise normal. Right eye : A red hemispherical fleshy mass. measuring 5 mm X 5 mm, was found attached to the nasal limbus by a narrow pedicle [Figure - 1]. The surface of the swelling was smooth and moist. It was not tender. The rest of eye structures and adnexa were normal The regional lymph glands were not enlarged. An excisional biopsy was done and the base was thoroughly fulgurated by diathermy The diagnosis was established by histopathological examination, which showed a lesion containing numerous thin walled blood vessels, many proliferating young fibroblasts and marked inflammatory cellular infiltrates consisting of lymphocytes, plasma cells, and poly morphonuclear leucocytes in a loose oedematous connective tissue stroma [Figure - 1]. The patient was followed up for five years. There was no recurrence.
| Discussion | | |
Granuloma pyogenicum is a rapidly developing small pedunculated highly vascular tumour varying in size from a pin-head to a cherry. In the eye it has been reported to arise mostly from lid skin[3],[6] its occurrence on the limbus is a rarity[7],[8],[9].
The etiology of the condition is obscure. In some respects it resembles a fungating granuloma of infective origin and in other respects a capillary angioma. Duke-Edler[10], felt that probably its apparent infective nature was superimposed on an angioma. It is commonly associated with a history of previous infection or trauma at the local site. However, none of these factors appeared to be operative in the present case and the nature of stimulus that initiated a vasoformative reaction remained unknown.
Several authors have emphasized the frequency with which granuloma pyogenicum recurs after excision[1],[2]. It may be recalled. that in two of the three cases of granuloma pyogenicum of the limbus published earlier[7],[8],[9] the lesion had recurred. However, in the present case a 5-year follow-up after the surgical excision and fulguration of the base showed no recurrence.
| Summary | | |
A case of granuloma pyogenicum of limbus in a 60-year-old man is reported. The lesion appeared in an apparently healthy limbus. There was no entecedent traumatic or inflammatory episode at the local site. A 5-year follow up after the surgical excision and fulguration of the base of the lesion revealed no recurrence.
| References | | |
| 1. | Evans. C.D. and Warin, R.P.. 1957, Brit J. Ophthalmol. 69: 106.  |
| 2. | Goskep, R.J. and Mehregan, A.H., 1967. Arch. Ophthalmol. 96 : 71. |
| 3. | We scott, C.D., 1916„ J. Amer. Mcd. Assoc. 66. 2067. |
| 4. | Hagedoorn. A., 1934. Brit. J. Ophthalmol. 18 561. |
| 5. | Malik, S. R.K., Sood. G.G. and Aurora, A.L., 1964, Brit. J. Ophthalmol. 48: 502. |
| 6. | Mohan, H and Gupta. AN, 1968, Amer. J. Ophthalmol. 65 :619. |
| 7. | Ferry, A.P. and Zimmerman, L.E., 1965, Arch, Ophthalmol. 66 :957. |
| 8. | Tulevech, C.B. and Cabaud. P., 1968, Amer. J. Ophthalmol. 66 : 957. |
| 9. | Boockvar, W., Wessely, Z. and Poter, B., 1974, Arch. Ophthalmol. 91 : 42. |
| 10. | Duke-Edler, S., 1965, System of Ophthalmology, Vol. 8, pt. 2, Kimpton, London, P. 1202. |
[Figure - 1]
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