Solitary Conjunctival Xanthoma at the Plica Semilunaris

Abstract

Purpose: To report a case of conjunctival xanthoma occurring at the plica semilunaris. Case summary: A 39-year-old female with no specific medical history visited our hospital due to a recent incidental detection of a painless mass in the nasal conjunctiva of her right eye. Slit-lamp bio-microscopic examination revealed a yellowish movable oval mass with inner semi-translucency in the temporal area of the plica semilunaris. The vertical length of the mass was approximately 8 mm. It was well-demarcated at its temporal border; however, the nasal border was obscured behind the plica semilunaris. Considering a possible conjunctival reactive lymphoid hyperplasia, topical and systemic steroids as well as oral doxycycline were administrated for 1 week; however, the lesion showed no improvement. An excisional biopsy was performed; pathological diagnosis indicated conjunctival xanthoma. The patient's blood lipid profile was within the normal range. Conclusion: Conjunctival xanthoma can develop near the plica semilunaris. Because it is difficult to distinguish xanthoma from other diseases including orbital fat prolapse or lymphoproliferative disease, rapid biopsy would be helpful for an early diagnosis.