Oman Journal of Ophthalmology

CLINICAL QUIZ
Year
: 2013  |  Volume : 6  |  Issue : 3  |  Page : 210-

The query of ectodermal ectopia


Shivali V Kashikar 
 Department of Radiology, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha Maharashtra, India

Correspondence Address:
Shivali V Kashikar
Department of Radiology, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha Maharashtra
India




How to cite this article:
Kashikar SV. The query of ectodermal ectopia.Oman J Ophthalmol 2013;6:210-210


How to cite this URL:
Kashikar SV. The query of ectodermal ectopia. Oman J Ophthalmol [serial online] 2013 [cited 2022 Dec 1 ];6:210-210
Available from: https://www.ojoonline.org/text.asp?2013/6/3/210/122282


Full Text

 Questions



What is the diagnosis based on imaging characteristics?[Figure 1]{Figure 1}What are the differential diagnoses?

 View Answer

 Answers



Orbital dermolipoma. Computed tomography of the orbits shows a hypodense, lentiform mass of size 1.1 Χ 0.5 cm giving fat attenuation [Figure 2]. It is medial to the lacrimal gland, anterior to the insertion of lateral rectus without any calcification in it. On magnetic resonance imaging, it is hyperintense on T1-[Figure 3] and T2-weighted imaging [Figure 4] and showed suppression on fat saturated imaging. Histopathology showed presence of squamous epithelium and adipose tissue.{Figure 2}{Figure 3}{Figure 4}The differential diagnoses of fat-containing epibulbar masses are limbal dermoid, subconjunctival fat prolapse and lipoma.

 Discussion



Dermolipoma is presumed to be a congenital solid choristoma developing due to sequestration of the ectoderm in the conjunctiva at the time of embryonic development of the eyelid. [1] The commonest location for both subconjunctival fat prolapse and dermolipoma is the lateral canthal area below the temporal or superotemporal bulbar conjunctiva. Subconjunctival fat prolapse affects elderly obese men and presents as a unilateral or bilateral soft yellowish mass having a convex anterior margin which becomes prominent with retropulsion of the globe. On the contrary, dermolipoma is a congenital lesion with a female preference and presenting early in life. It manifests as a unilateral soft or firm pinkish-yellow mass with a straight or slightly concave anterior margin. It is frequently accompanied by fine hairs on the surface. It is not freely movable, cannot be repositioned into the orbit, and lesion size is not affected by retropulsion of the globe. [2] Histologically, dermolipoma show stratified squamous epithelium and various amounts of collagenous connective tissue and a disproportionate amount of adipose tissue in the subepithelial stroma. Surgical resection of dermolipoma should be done conservatively as wide or complete excision may cause complications which are unacceptable for an essentially cosmetic problem. [1]

References

1Eijpe AA, Koornneef L, Bras J, Verbeeten B Jr, Peeters FL, Zonneveld FW. Dermolipoma: Characteristic CT appearance. Doc Ophthalmol 1990;74:321-8.
2Kim YD, Goldberg RA. Orbital fat prolapse and dermolipoma: Two distinct entities. Korean J Ophthalmol 1994;8:42-3.