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Maria Paula Fernandez, Antonio Bermudez, Sander R Dubovy, Eduardo C Alfonso, Victor L Perez, Guillermo Amescua, Richard K. Forster; Clinicopathologic correlation of Corneal Keloid-like Myoblastic Fibrocellular Proliferation. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):744.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinicopathologic findings of 9 cases presenting with keloid-like myoblastic fibrocellular proliferation of the cornea.
In a non-comparative, consecutive case series, the database at the Florida Lions Ocular Pathology Laboratory was searched for surgical specimens diagnosed with keloid-like myoblastic proliferation on light microscopic examination from the time period of 1998 to 2014. The specimens were reviewed and the clinicopathologic features were evaluated.
The diagnosis of keloid-like myoblastic proliferation was established by light microscopic examination of formalin fixed, paraffin embedded tissue from the corneas of 9 eyes (Right = 3, Left = 6). From this group of nine patients 5 were females and 4 males. The age of presentation ranged from 2 to 79 years, and 5 of 9 patients were under 10 years of age. The mean age of presentation was 22 and the median was 9. Findings on clinical presentation were corneal opacification and/or scarring associated to trauma (1), infection (2), perforation (1), keratoconus (1), previous ocular surgery (1) and family history of keloid formation (2). Only one presented with bilateral scarring since birth (11%). Five of the patients underwent Penetrating Keratoplasty (PK), two underwent excisional biopsy, one underwent lamellar keratectomy and the other one underwent superficial keratectomy. On histopathological examination all demonstrated a spindle cell fibrocellular proliferation within the corneal stroma that stained positively for smooth muscle actin (SMA).
A corneal keloid-like fibrocellular proliferation can present as a progressive growing whitish lesion and is believed to be the result of an abnormal healing process, although cases of keloid-like myofibroblastic proliferation without evidence of prior trauma of inflammation have been reported. Font et al had previously reported two cases of bilateral keloid-like myofibroblastic proliferations in two children.We reviewed 9 cases of which 5 were under 10 years of age and the remainders were over the age of 20. In our case series review we demonstrate that this process can occur unilaterally as well as in young and old adults. On histopathological examination all of them showed fibrocellular proliferation within the corneal stroma with spindle shaped cells that stained positive for SMA.
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