J Korean Ophthalmol Soc > Volume 61(10); 2020 > Article
Journal of the Korean Ophthalmological Society 2020;61(10):1221-1224.
DOI: https://doi.org/10.3341/jkos.2020.61.10.1221    Published online October 15, 2020.
Conjunctival Fibroma after Excision of a Recurrent Pterygium
Jung Suk Yoon, Byung Yi Ko
Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea
재발 군날개수술 후 발생한 결막섬유종
윤정석, 고병이
건양대학교 의과대학 안과학교실
Correspondence:  Byung Yi Ko, Tel: 82-42-600-9258, Fax: 82-42-600-9251, 
Email: kopupil@hanmail.net
Received: 31 December 2019   • Revised: 5 April 2020   • Accepted: 22 September 2020
Abstract
Purpose
To report a case of conjunctival fibroma after excision of a recurrent pterygium.
Case summary
A 44-year-old male was referred with pterygium recurrence. The patient had undergone pterygium surgery on his left eye 7 years prior. Examination of the conjunctiva revealed fibrovascular proliferative tissue that had grown onto the cornea at the medial limbus in his left eye. The patient underwent pterygium excision, amniotic membrane transplantation, and intraoperative 0.02% mitomycin C soaking. Pterygium was confirmed histologically. Two years after surgery, a 5 × 3 mm semi-translucent, white conjunctival mass at the medial limbus was found in the left eye. The best-corrected visual acuity was 1.0 in both eyes and the intraocular pressure was within normal limits. Suspecting recurrent pterygium, the patient underwent excision of the conjunctival mass, conjunctival autograft, and 0.02% mitomycin C soaking during surgery. Under histologic examination, paucicellular substantia propria with abundant collagen and scattered fibroblasts was observed; the mass was diagnosed as conjunctival fibroma. No sign of recurrence was evident 2 years postoperatively.
Conclusions
Although conjunctival mass after pterygium excision is likely to be recurrent pterygium in most cases, there is the rare possibility of conjunctival fibroma; thus, histologic examination should be performed for differential diagnosis.
Key Words: Conjunctiva, Fibroma, Pterygium
국문초록
목적
재발 군날개수술 후 발생한 결막섬유종 1예를 경험하였기에 보고한다.
증례요약
44세 남자 환자가 좌안의 재발 군날개로 의뢰되었는데, 내원 7년 전 좌안의 군날개절제술을 받은 과거력이 있었다. 세극등 현미경검사에서 좌안의 내측 각막윤부에 결막 쪽에서 각막으로 자라온 섬유혈관조직이 관찰되었다. 좌안의 군날개절제술, 양막이식술을 시행하고, 술 중 0.02% 마이토마이신C를 사용하였다. 조직검사 결과 군날개로 진단되었다. 수술 후 2년째 좌안 비측 각막윤부에 5 x 3 mm 크기의 반투명한 백색의 결막 종괴가 발견되었다. 최대교정시력은 양안 1.0이었고, 안압은 정상이었다. 군날개의 재발을 의심하고, 결막종괴 절제 및 생검, 자가결막이식술을 시행하고, 술 중 0.02% 마이토마이신C를 사용하였다. 조직검사에서 치밀한 아교질과 산재한 섬유아세포로 구성된 세포 수가 적은 종양이었으며, 결막섬유종으로 진단되었다. 수술 후 2년까지 재발 없이 경과 관찰 중이다.
결론
군날개수술 부위에서 발생한 결막 종괴는 군날개의 재발이 많지만, 드물게 결막섬유종의 가능성도 생각하여야 하며, 확진을 위해 조직검사를 시행하는 것이 바람직하다.


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