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Epibulbar choristoma

Author: Deepali Jain, M.D.

Last author update: 1 April 2017

Last staff update: 5 November 2024 (update in progress)

Copyright: 2004-2024, PathologyOutlines.com, Inc.

PubMed Search: Dermoid tumor and other congenital lesions

Table of Contents

Cite this page: Jain D. Epibulbar choristoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyedermoidtumor.html. Accessed December 26th, 2024.

Definition / general

A type of choristoma (congenital, nonneoplastic lesion composed of cytologically normal tissue not normally found at that location), often at limbus
Mainly children
No malignant potential
May be associated with colobomas of iris and ciliary body, Goldenhar syndrome (ocular dermoid tumors, extra-auricular appendages, vertebral anomalies, East Afr Med J 2002;79:502), organoid nevus syndrome (also called linear nevus sebaceus of Jadassohn, Br J Ophthalmol 1987;71:268)

Diagrams / tables

Images hosted on other servers:

Complex choristoma (figure 1b)

Clinical images

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Lipodermoid

Gross description

Bulbar tumors are firm, localized, elevated, opaque, yellow-white masses at limbus

Microscopic (histologic) description

Dermoid:
- Solid (not cystic) choristoma mass with surface epithelium resembling epidermis and dermis and containing a few hairs, overlying thick bundles of collagen, which make up bulk of mass (eMedicine: Limbal Dermoid [Accessed 17 April 2018])
Complex choristoma:
- Cartilage, lacrimal tissue, smooth muscle, adipose tissue, neural tissue (Ophthalmology 1987;94:1249)
- May be confused with prolapsed lacrimal gland (Acta Ophthalmol Scand 2005;83:100); teeth (odontogenic choristoma, Am J Ophthalmol 2009;147:531)
Osseous choristoma:
- More than 70% female
- Small, solid, circumscribed, red-white bony lesion behind limbus and between superior and lateral rectus muscles
- Composed of compact lamellar bone surrounded by dense, collagenous bone (Br J Ophthalmol 1979;63:173, Ophthalmic Surg Lasers 2002;33:410)
Dermolipoma (lipodermoid):
- Superotemporal most common site
- Abundant adipose tissue but minimal skin adnexae, usually in upper outer fornix; only superficial portion is excised as deep portion is attached to rectus muscles and fascia (The Internet Journal of Ophthalmology and Visual Science 2006;4:Number 1, Arch Ophthalmol 1994;112:1114)
- Resembles subconjunctival herniated orbital fat (Aust N Z J Ophthalmol 1999;27:33)
Smooth muscle hamartoma:
- Gray, cyst-like appearance
- Spindled smooth muscle, fibrous stroma, lobules of adipose tissue (Am J Ophthalmol 1999;128:643, Ophthal Plast Reconstr Surg 2012;28:e102)