Corneal Edema as the Primary Symptom of Xanthogranuloma
Uhlig C. E., Busse H.
University Eye Hospital Muenster
Purpose: We report on a 6-month old girl who presented at our hospital with an opaque cornea and a presumed herpes-keratitis.
Method: Case report. Clinical examination of the anterior and posterior chamber including tonometry, gonioscopy, fundoscopy and A- and B-scan ultrasonography in general anaesthesia.
Results: The right cornea was edematous. Yellow-brown masses were found in the anterior chamber angle and the iris stroma was hyperemic. Fundoscopy and ultrasonography of the vitreoretinal space revealed no further tumor. The left eye presented a transparent cornea and a posterior embryotoxon. Intraocular pressure was 30 mm Hg in the right eye and 12 mm Hg on the left side. The patients age, the colour and the localisation of the tumour supported the diagnosis of a xanthogranuloma. Strontium 90 was applied four times during 14 days (1.05 Gy HD x 4). Fluorometholon, neomycin and timolole eye-drops were additionally applied. Three months later the tumour mass was significantly smaller and the intraocular pressure 13 mm Hg.
Conclusions: Juvenile xanthogranulomas are orange or reddish brown tumors in infants. They may appear as solitary lesions and usually resolve spontaneously, but lesions in the iris can bleed and produce spontaneous hyphema, uveitis, and secondary glaucoma. Further therapeutic options are the application of steroids, surgical procedures to remove the tumour, or radiotherapy. The repetitive use of strontium in our case resulted
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