양안 위눈꺼풀에 발생한 표피하 석회 결절
Bilateral Subepidermal Calcified Nodules of the Upper Eyelid
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목적: 소아에서 발생한 양안 위눈꺼풀의 표피하 석회 결절 1예를 보고하고자 한다. 증례요약: 과거 외상의 기왕력이나 전신질환의 과거력이 없는 5세 여자 환자가 8개월 전부터 발생한 양안 상안검의 종괴를 주소로 내원하였다. 종괴는 통증 없이 서서히 크기가 커졌으며, 단단하고 황백색으로 돌출되어 있었다. 우안의 병소는 내안각 주변의 위눈꺼풀에 위치하였으며, 크기는 0.2 × 0.2 cm였다. 좌측의 병소는 우안에 비해 조금 더 내측에 위치하고 있었으며, 크기는 0.2 × 0.1 cm였다. 소아황색육아종, 물사마귀로 의심하여 절제생검을 실시하였다. 병리검사상 병변은 다양한 크기의 칼슘 침착물을 포함하고 있었으며, 과증식되거나 과다각화증을 보이는 상피조직의 아래 혹은 과다각화증을 보이는 상피조직내에 위치하고 있었다. 표피하 석회 결절로 진단되었으며, 절제 후 재발 없이 잘 회복되었다. 결론: 눈꺼풀에서 발생한 통증이 없는 황백색의 융기성 병변에 대해서는 표피하 석회 결절을 감별진단으로 고려해야 한다.
Abstract
Purpose: To report a case of bilateral subepidermal calcified nodules of the upper eyelid in a child. Case summary: A 5-year-old girl with no history of trauma or systemic disease was referred for assessment of bilateral eyelidmasses that had appeared 8 months prior. The masses grew slowly without pain, and were hard, elevated, and yellowish-whitein color. The right eyelid mass was close to the medial canthus and measured 0.2 × 0.2 cm. The mass of the left upper eyelid wassmaller (0.2 × 0.1 cm) and closer to the medial side. The clinical impression was juvenile xanthogranuloma and molluscumcontagiosum. Excisional biopsy of the bilateral eyelid masses was performed. Histologic findings revealed that the lesions werecomposed of variable-sized multiple calcium deposits, lined by hyperplastic and hyperkeratotic epidermis or within the hyperkeratoticepidermis. The diagnosis was subepidermal calcified nodules (SCNs) for both of the bilateral eyelid masses. The patientmade a complete recovery after the excision, without recurrence. Conclusions: SCNs should be considered during differential diagnosis of a painless, elevated, yellowish-white eyelid lesion.
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