CASE REPORT


Conjunctival Balloon Cell Nevus in a Young Child: A Case Report



Wasee Tulvatana1, *, Anapat Sanpavat2, Duangnate Rojanaporn3, 4, Nopadon Noppakun5
1 Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
2 Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
3 Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
4 Rutnin Eye Hospital, Bangkok, Thailand
5 Dermatopathology Unit, Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand


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Creative Commons License
© 2022 Tulvatana et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Patumwan, Bangkok 10330, Thailand; Tel: 6622564000; E-mail: waseetulvatana@chula.md


Abstract

Background:

Conjunctival balloon cell nevus is rare and often presents in young adults to middle-aged patients with a longstanding history of melanocytic lesion, suggestive of benign pathology. The main treatment modality is excisional biopsy. Tumor recurrence is very rare. Malignant transformation has never been reported.

Objective:

This study aimed to report a case of conjunctival balloon cell nevus with an atypical presentation in a preschooler.

Methods:

We describe a case of a 5-year-and-9-month-old girl who presented with a rapidly growing melanocytic conjunctival mass, which she had since birth. Ophthalmic examination showed two prominent feeder vessels, and the lesion straddled the limbus to overlie the peripheral part of the cornea. These findings raised an index of suspicion of malignant transformation. The lesion was completely excised with a 2-mm resection margin, superficial keratectomy, ethyl alcohol epitheliectomy, and cryotherapy.

Results and Discussion:

The histopathological examination and immunohistochemical study showed a compound conjunctival nevus of the conjunctiva with most of the cells as balloon cell type. There were no malignant changes found. Moreover, there were no signs of tumor recurrence at the last follow-up of 6 months.

Conclusion:

Clinically malignant characteristics have never been reported in balloon cell nevi in a preschooler of this age. Thorough physical examination, well-planned surgical procedure, and careful pathological examination all play vital roles in the management of patients with these lesions.

Keywords: Balloon cell nevus, Case Report, Compound nevus, Conjunctiva, Nevus, Preschooler, Young child.