Eur J Ophthalmol. 2021 Oct 16;11206721211052879. doi: 10.1177/11206721211052879. Epub 2021 Oct 16.

A case of nodular episcleritis mimicking a solitary giant episcleral mass.

European journal of ophthalmology

Lan Zhou, Juanjuan Wang, Guihua Xu, Dingding Wang, Xiaoyi Wang, Zilin Chen

PMID: 34657499 DOI: 10.1177/11206721211052879

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.

Keywords: Nodular episcleritis; episcleral mass; histopathologic; steroid

Publication Types

• Journal Article