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      Atypical Fibroxanthoma of the Bulbar Conjunctiva: A Unique Case Describing the Pathology, Clinical Presentation, and Management

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          Abstract

          Background/Aims

          Atypical fibroxanthoma is an uncommon tumor that usually occurs in the skin of the head and neck of the elderly with significant sun exposure. We describe a unique case featuring a rare ocular surface conjunctival tumor (atypical fibroxanthoma) and provide insight on its characteristic clinical features, surgical management, and histology.

          Methods

          A 71-year-old male fisherman with no pertinent ocular history presented to an academic center with a rapidly enlarging bulbar conjunctival mass in the right perilimbal region for the past several months. The patient underwent surgical excisional biopsy with cryotherapy, adjuvant alcohol, and amniotic membrane transplantation.

          Results

          Pathology specimen illustrated an atypical spindle cell tumor with inflammatory cells, increased mitotic activity, cytologic atypia, and positive diffuse staining with CD163 and CD10 consistent with an atypical fibroxanthoma.

          Conclusion

          Atypical fibroxanthoma is an extremely rare ocular surface tumor that may simulate conjunctival or ocular surface squamous neoplasia. While this lesion typically pursues a benign clinical course, it may recur or rarely metastasize. Thus it should be treated aggressively with excisional biopsy, cryotherapy, absolute alcohol, and/or amniotic membrane transplantation.

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          Author and article information

          Journal
          Ocul Oncol Pathol
          Ocul Oncol Pathol
          OOP
          Ocular Oncology and Pathology
          S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.ch )
          2296-4681
          2296-4657
          April 2018
          20 October 2017
          1 April 2019
          : 4
          : 3
          : 152-156
          Affiliations
          The Ohio State University Department of Ophthalmology, Columbus, OH, USA
          Author notes
          *Justin Kuiper, The Ohio State University Department of Ophthalmology, 915 Olentangy River Road, Columbus, OH 43212 (USA), E-Mail justin.j.kuiper@ 123456gmail.com
          Article
          PMC5939675 PMC5939675 5939675 oop-0004-0152
          10.1159/000480088
          5939675
          29765945
          Copyright © 2017 by S. Karger AG, Basel
          Page count
          Figures: 3, References: 15, Pages: 5
          Categories
          Novel Insights from Clinical Practice

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