결막에 발생한 원발거대세포종 1예

A Case of Primary Conjunctival Giant Cell Tumor

목적: 결막에 발생한 원발거대세포종 1예를 보고하고자 한다. 증례요약: 67세 여자 환자가 10년 전 발생한 좌안의 결막 종괴로 내원하였다. 종괴 크기의 갑작스런 변화는 없었다고 하며, 시력 및 안압은 정상이었다. 결막 종괴는 좌안 8시 방향에 각막윤부를 침범하여 5 × 4 × 2 mm 크기로 돌출되어 있었으며 경계가 명확하고 분홍빛을 띤 소엽화된 형태를 보였다. 종괴 주위로 결막 충혈이 동반되어 있었고 압통 및 통증은 없었다. 결막 종괴에 대하여 광범위 절제술 및 양막이식술과 함께 조직검사를 시행하였다. 조직병리검사에서 다핵 거대세포가 관찰되고 추가로 실시한 면역조직화학염색 결과에서 CD68과 vimentin에서 양성을 보여 거대세포종임을 최종 확인하였다. 결론: 거대세포종이 결막에 발생한 최초의 증례로 다른 융기성 결막종양과의 감별진단이 필요할 것으로 생각되며, 수술적 치료를 통해 거대세포종의 완전제거와 미용적 회복을 얻을 수 있다. <대한안과학회지 2016;57(11):1786-1789>

Purpose: To report a case of primary conjunctival giant cell tumor (GCT). Case summary: A 67-year-old female visited our clinic with the chief complaint of a 10-year-history of conjunctival mass in the left eye. The patient had no marked changes in the mass size, and her visual acuity and intraocular pressure were within the normal range. The protruding conjunctival mass invaded the limbal area at the 8 o’clock direction in the left eye and was 5 × 4 × 2 mm in size. Moreover, the pink-colored mass had a lobulated shape with a well-defined margin. In the adjacent mass region, concurrent presence of the conjunctival injection was observed. However, the patient did not exhibit pain or tenderness. We performed wide excision of the conjunctival mass concomitantly with amniotic membrane transplantation. Then, histopathological examinations and immunohistochemical staining of the surgical site were performed. On histopathology, the patient had findings suggestive of GCT. Additionally, immunohistochemistry was positive for CD68 and vimentin. leading to the final diagnosis of GCT. Conclusions: To our knowledge, this is the first case of GCT of the conjunctiva, which has not been described in the literature. Our case highlights the importance of differential diagnosis from other protuberant conjunctival tumors. A complete removal of GCT of the conjunctiva and a recovery of aesthetic outcomes can be achieved by surgical excision of the mass. J Korean Ophthalmol Soc 2016;57(11):1786-1789