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   Table of Contents      
CASE REPORT
Year : 2018  |  Volume : 66  |  Issue : 3  |  Page : 455-456

An unusual case of corneal lipoma


1 Department of Cornea, Ruby Eye Hospital; Department of Ophthalmology, Hitech Medical College, Bhubaneswar, India
2 Department of Ophthalmology, Hitech Medical College, Bhubaneswar, India
3 Department of Cornea, Ruby Eye Hospital, Bhubaneswar, India
4 Department of Ophthalmology, M.K.C.G Medical College and Hospital, Berhampur, India
5 Department of Ophthalmology, SDH, Chatrapur, Odisha, India

Date of Submission04-Oct-2017
Date of Acceptance11-Dec-2017
Date of Web Publication26-Feb-2018

Correspondence Address:
Dr. Praveen Subudhi
Ruby Eye Hospital, Govinda Vihar, Berhampur, Ganjam, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_912_17

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  Abstract 


A 24-year-old male presented with a painless yellowish lesion on the nasal part of his cornea that extended to the paracentral area. Without a confirmed clinical diagnosis, the patient was advised surgical removal of the lesion. The lesion showed a smooth, elevated anterior surface without any signs of inflammation. On making a small incision over the lesion, we found yellowish material being extruded from the lesion. Cytological evaluation of the material revealed clear vacuolated cells suggestive of lipocytes, based on which we diagnosed it a rare case of corneal lipoma.

Keywords: Adipocytes, cornea, lipoma


How to cite this article:
Subudhi P, Khan Z, Patro S, Subudhi B N, Sitaram S. An unusual case of corneal lipoma. Indian J Ophthalmol 2018;66:455-6

How to cite this URL:
Subudhi P, Khan Z, Patro S, Subudhi B N, Sitaram S. An unusual case of corneal lipoma. Indian J Ophthalmol [serial online] 2018 [cited 2024 Mar 28];66:455-6. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?2018/66/3/455/226129



Lipomas are commonly reported in the extremities and trunk, but orbital lipoma is rare.[1] Herein, we present an unusual case of a corneal lipoma.


  Case Report Top


A 24-year-old male presented with complaints of a painless yellowish lesion over the surface of his right eye that had steadily grown over a year. Slit lamp examination revealed a yellow placoid lesion at the limbus, extending toward the center of the cornea. The surface of the cornea and adjacent conjunctiva were smooth, and there were no signs of inflammation [Figure 1]a. The patient was advised surgical removal of the mass. When a small incision was made in the superior aspect of the lesion, and gentle pressure was applied, yellowish material extruded from it [Figure 1]b. The material was collected, placed on a slide, and sent for cytopathological examination. Intraoperatively, we noted that there was a cleavage within the corneal stroma filled with the yellowish material. The remainder of the material was aspirated and washed with normal saline [Figure 1]c. We further observed that the yellowish material extended to the intrascleral space adjacent to the cornea. Hence, we presumed the lesion was possibly an intrascleral lipoma with corneal extension [Figure 1]d. Cytopathological examination confirmed the presence of lipid material containing clear vacuolated fat cells with the nuclei pushed to the periphery. There was no evidence of inflammatory cell infiltration [Figure 2]. Immunohistochemistry confirmed S100 positivity, suggestive of mature adipocytes. Postoperatively, the patient recovered well, with a clear cornea at the site of the lesion. There was no recurrence at 6-week follow-up [Figure 3].
Figure 1: (a) A smooth surfaced yellow lesion in the nasal part of the cornea in the left eye (b) Surgical incision given over the lesion (c) Showing yellowish lipid-like material extruding out (d) Demonstration of lamellar scleral extension of the lesion

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Figure 2: Multiple vacuolated cells seen in hematoxylin and eosin stain with nucleus pushed to periphery suggestive of mature adipocytes

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Figure 3: Postoperative picture of the eye at the end of 6 weeks showing no recurrence

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  Discussion Top


Lipomas are well-circumscribed benign lesions filled with fat cells in lobules surrounded by connective tissue. A meta-analysis of the largest orbital tumor series demonstrated a very low incidence of lipoma.[2] A review of 1264 consecutive lesions conducted by Shields et al. reported only two lipomas, which is indicative of the rarity of this benign tumor in the eye and orbit.[3] The occurrence of lipomas and their variants in various parts of the orbit has been reported worldwide; however, lipomas are rarely observed in the cornea.[4],[5],[6] Lipomas are always confused with the prolapse of the retro-orbital fat, which commonly occurs in the superotemporal aspect of the globe.[7] The cornea is an avascular structure of the globe; thus, the occurrence of a lipoma is theoretically confounding; however, the extension of a lipoma from the limbal area into the cornea is possible. Congenital dermolipoma of the limbus is rarely observed in isolation or as part of a syndrome, but histopathology usually reveals a dermatological component in addition to lipocytes.[8] In our case, cytopathological examination revealed only mature adipocytes, confirmed by S100 positivity on immunohistochemistry.[9]


  Conclusion Top


The rare possibility of lipoma may be considered in a yellow corneal lesion with smooth surface.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Tahiri Y, Xu L, Kanevsky J, Luc M. Lipofibromatous hamartoma of the median nerve: A comprehensive review and systematic approach to evaluation, diagnosis, and treatment. J Hand Surg Am 2013;38:2055-67.  Back to cited text no. 1
[PUBMED]    
2.
Kim MH, Sa HS, Woo K, Kim YD. Fibrolipoma of the orbit. Ophthal Plast Reconstr Surg 2011;27:e16-8.  Back to cited text no. 2
[PUBMED]    
3.
Shields JA, Shields CL, Scartozzi R. Survey of 1264 patients with orbital tumors and simulating lesions: The 2002 montgomery lecture, part 1. Ophthalmology 2004;111:997-1008.  Back to cited text no. 3
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4.
Tripathy D, Mittal R. Spindle cell lipoma of the orbit. Ophthal Plast Reconstr Surg 2015;31:e53-5.  Back to cited text no. 4
[PUBMED]    
5.
Ali SF, Farber M, Meyer DR. Fibrolipoma of the orbit. Ophthal Plast Reconstr Surg 2013;29:e79-81.  Back to cited text no. 5
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6.
Koganei Y, Ishikawa S, Abe K, Mukuno K, Shioya N. Orbital lipoma. Ann Plast Surg 1988;20:173-82.  Back to cited text no. 6
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7.
Kim E, Kim HJ, Kim YD, Woo KI, Lee H, Kim ST, et al. Subconjunctival fat prolapse and dermolipoma of the orbit: Differentiation on CT and MR imaging. AJNR Am J Neuroradiol 2011;32:465-7.  Back to cited text no. 7
    
8.
Punia RS, Nanda A, Mohan H, Bansal RK. Clinicopathological study of dermolipoma – A report of four cases. Indian J Pathol Microbiol 2006;49:605-7.  Back to cited text no. 8
[PUBMED]    
9.
El Amine El Hadj O, Bouraoui S, Ben Fadhel CG, Lahmar A, Mzabi-Regaya S. Lipoma of the uterus: Clinical and ethiopathological approach of 7 cases with immunohistochemical study of histogenesis. Tunis Med 2010;88:916-9.  Back to cited text no. 9
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    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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