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J. Song, M. Kurli, S. Schneider, P.T. Finger; High Frequency Ultrasound (UBM) Evaluation of Giant Conjunctival Inclusion Cysts . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4299.
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To evaluate the use of ultrasound biomicroscopy (UBM) in the diagnosis and management of secondary conjunctival inclusion cysts.
This study is a retrospective case series including 3 patients with giant conjunctival inclusion cysts. The patients were assessed clinically and with ultrasound biomicroscopic examination (to evaluate size and involvement of underlying structures). The tumors were excised and histopathologic evaluation confirmed diagnosis of epithelial–lined inclusion cysts.
All three patients had a history of previous ocular surgery in the area of cyst formation. One of the cysts was pigmented. Ultrasound biomicroscopy revealed large cystic tumors in all three patients. The cysts were well circumscribed with low internal reflectivity. There appeared to be no involvement of the underlying structures in 2 patients. One demonstrated encapsulation of the medial rectus muscle with deformation of the globe and the presence of calcifications along its anterior margin on ultrasonographic evaluation (Figure). Computed tomography demonstrated separation between the cyst and the underlying muscle as well as globe displacement. Histopathologic assessment of this cyst revealed a stratified squamous epithelium lining with occasional goblet cells and fibrous reaction. Focal areas of dystrophic calcification were noted around the cyst.
Ultrasound biomicroscopy can aid in the evaluation of conjunctival inclusion cysts. The cystic nature, the size of the tumor and potential involvement of adjacent structures can be determined by ultrasonographic evaluation. Ultrasound was also used to determine the extent of the tumor prior to excisional biopsy.
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