Inferomedial Dermolipoma With Ectopic Lacrimal Gland

Abstract

A 25-year-old woman presented with a painless inferomedial subconjunctival mass in the right eye. The growth had been present since birth and had been increasing in size for over 1 year. Incisional biopsy with debulking proved the lesion to be a dermolipoma extending behind the globe that contained ectopic lacrimal gland tissue. The authors describe a very rare case of a complex dermolipoma arising in an atypical location and containing ectopic lacrimal gland.

Ectopic lacrimal gland in a complex choristoma involving the lacrimal sac fossa

“…Complex choristomas with ectopic lacrimal gland have been noted to have a predisposition to bulbar conjunctiva and cornea, although it has been reported from eyelids, orbits and intraocular tissues such as ciliary body and iris 1, 2, 3, 4, 5. Numerous theories have been proposed to explain the occurrence of choristomas and ectopic lacrimal gland and include aberrant implantation of embryonic cells destined to differentiate into lacrimal gland and aberrations during closure of fissures and sutures 5…”

“…Only two of the 61 cases were correctly diagnosed preoperatively. Ferri et al 2 reported a case of an inferomedial subconjunctival dermolipoma with ectopic lacrimal gland and concluded that the location was quite atypical based on the literature review. Verb et al 4 described a phakomatous choristoma presented as a lower eyelid mass with a mechanical nasolacrimal duct obstruction.…”

“…Choristomas are congenital lesions where histologically normal tissues with little or no growth potential are present at abnormal locations 1 . Choristomas can be termed complex when multiple tissues such as lacrimal gland, bone, cartilage, nerve, muscles or brain are present 1, 2, 3. Choristomas with ectopic lacrimal gland have been reported in eyelids, bulbar conjunctiva, limbus, orbits and intraocular tissues 1, 2, 3, 4, 5.…”

“…Choristomas can be termed complex when multiple tissues such as lacrimal gland, bone, cartilage, nerve, muscles or brain are present 1, 2, 3. Choristomas with ectopic lacrimal gland have been reported in eyelids, bulbar conjunctiva, limbus, orbits and intraocular tissues 1, 2, 3, 4, 5. We describe a male child, 2 years of age with ectopic lacrimal gland in complex choristomas involving the lacrimal sac fossa and partly the medial eyelid along with a brief review of literature.…”

Dermolipoma in an Unusual Location: A Case Report and Literature Review

“…Dermolipomas located in other quadrants are rare. As for the inferonasal quadrant, there have been only three reported cases of inferonasal dermolipoma published in the literature [ 5 - 7 ]. This is not the typical location for dermolipomas, hence emphasizing the unusual presentation of this case.…”