A case of nodular episcleritis mimicking a solitary giant episcleral mass

Abstract

Purpose To describe an atypical nodular episcleritis mimicking a solitary giant episcleral mass, which is not attributed to any systemic diseases and identified only after immunohistochemical examination. Case report A sixty-year-old Chinese woman with systemic hypertension presented with 6-month history of giant, solitary and redness epibulbar mass arising from the superior aspect of her left eye. The lesion gradually enlarged, even with 6-month history of irregular topical steroid eye drops treatment. Imaging studies and laboratory test revealed a 10 mm × 8 mm episcleral mass absence of any infection indicator and autoimmune antibody changes. The mass was completely removed before its extension through the deep scleral, histopathologic examination revealed a nodular episcleritis composed of various chronic inflammatory cells infiltration. Topical steroid eye drops treatment combined with oral steroidal anti-inflammatory drugs was then administrated regularly for 1 month, and no recurrence occurred after 1-year follow-up. Conclusion Nodular anterior episcleritis is characterized by underlying chronic inflammation of the anterior episclera and can be presented as asymptomatic episcleral mass. Besides a thorough investigation systemically, tissue biopsy is required for definite diagnosis.

Treatment of Steroid-Resistant Nodular Episcleritis With Tacrolimus: A Case Report

“…The idea for using tacrolimus in nodular episcleritis comes from its potent anti-inflammatory effect in addition to its uses in different ocular diseases. This is consistent with observations that these diseases have nearly similar predisposing and risk factors with nodular episcleritis as well as the pathogenesis of each with some differences [17,18].…”