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Complex choristoma of the eyelid containing ectopic cilia and lacrimal gland
A J Gordon1, J R Patrinely, J A Knupp
1Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030.
Insights
This is the first reported case of an eyelid choristoma with both ectopic cilia and lacrimal gland tissue. The rare congenital anomaly was successfully surgically removed in a 2-year-old girl.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Dermatopathology
Background:
- Congenital eyelid anomalies are rare, with ectopic cilia being an exceptionally uncommon finding.
- Choristomas, benign tumors composed of tissue normally found elsewhere, can occur in various locations, including the eyelid.
Observation:
- A 2-year-old female presented with a congenital aggregate of ectopic cilia on the right upper eyelid, causing intermittent tearing.
- Surgical excision revealed tightly clustered cilia with bulb-like follicles and adjacent ectopic lacrimal gland tissue posterior to the orbital septum.
Findings:
- Histopathological examination confirmed a choristoma containing multiple large hair follicles, adnexal structures, and ectopic lobules of lacrimal gland tissue.
- The ectopic cilia and lacrimal gland tissue were not directly connected.
Implications:
- This case represents the first documented instance of an eyelid choristoma incorporating both ectopic cilia and lacrimal gland tissue.
- Successful surgical management resulted in a good cosmetic outcome and no recurrence at 18-month follow-up.
- Highlights the importance of thorough histopathological evaluation for rare congenital eyelid malformations.
Abstract:
A 2-year-old girl was born with an aggregate of ectopic cilia in the right upper eyelid that intermittently produced tears. During elective excision, the cilia were found to be clustered tightly with prominent bulb-like follicles. A separate lobe of lacrimal gland tissue was adjacent to the roots of the cilia just posterior to the orbital septum with no direct communication with the lacrimal gland. Histopathologically, the lesion contained multiple large hair follicles in the dermis with accompanying adnexal structures. Large ectopic lobules of lacrimal gland tissue also were present. Postoperatively, the child had a good cosmetic result and has remained asymptomatic over an 18-month follow-up period. To our knowledge, this is the first reported case of an eyelid choristoma containing ectopic cilia and lacrimal gland. Ectopic cilia alone is a very rare anomaly of the lashes, with only nine cases reported in the literature.