title: Diffuse Epibulbar Complex Lacrimal-Cartilaginous Choristoma: Diagnostic Clues and Management.
abstract: OBJECTIVE
  To describe the clinical and histopathologic features distinguishing an extensive complex choristoma of the epibulbar surface and to address the management of such lesions.
  
  
  METHODS
  Clinical history, diagnostic imaging studies, and histopathologic sections stained with hematoxylin and eosin were reviewed from a 2-year-old girl with a congenital conjunctival lesion of the right eye that was surgically excised.
  
  
  RESULTS
  The patient clinically displayed an extensive, vascularized amelanotic conjunctival lesion located superotemporally with extension onto the cornea. Her visual acuity was reduced to 20/670. The clinical diagnosis was a large lacrimal gland choristoma with corneal involvement and resulting deprivation amblyopia. The patient underwent an excision of the lesion including the corneal portion, and the ocular surface was reconstructed with amniotic membrane. Histopathologic evaluation disclosed lobules of lacrimal tissue and cartilage plaques, smooth muscle, and nerves consistent with a complex choristoma. Six weeks postoperatively, the visual acuity had improved to 20/180. The patient returned to her local ophthalmologist for amblyopia management.
  
  
  CONCLUSIONS
  We emphasize the importance of recognizing lesion-induced amblyopia and the timely performance of appropriate surgery for complex epibulbar choristomas. A differential diagnosis of other congenital epibulbar lesions is provided.
authors.affiliation: *Department of Ophthalmology, Harvard Medical School, Boston, MA; †David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Boston, MA; ‡Cornea and Refractive Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA; and §Pediatric Cornea Service, Boston Children's Hospital, Boston, MA.
authors.forename: Seanna R
authors.initials: SR
authors.lastname: Grob
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Jakobiec
authors.forename: Anna M
authors.initials: AM
authors.lastname: Stagner
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Colby
mesh_terms: D002356:Cartilage; D002675:Child, Preschool; D002828:Choristoma / Q000175:diagnosis* / Q000601:surgery*; D003316:Corneal Diseases / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus; D009915:Orbit; D014792:Visual Acuity