Case Study: January 2010

A 30 year old presents with a white mass over the cornea.

At surgery, the lesion was located between the corneal epithelium and Bowman’s and the surgeon peeled it off without difficulty.

Figure 1 and Figure 2 show the lesion.

Figure 3 is an anti-smooth muscle actin immuno.

Figure 4 is an Alcian Blue stain.


1. What are the features of this lesion?
2. What is the differential diagnosis?
3. What is the most likeliest diagnosis?

Click to show answers
  1. Spindle cell myxoid lesion covered by epthelium
  2. Myxoid degeneration, primary corneal myxoma, Salzmann’s nodule (early cellular phase), nodular scarring, neurofibroma
  3. The patient had no history of corneal disease. The favoured differential is primary corneal myxoma


Corneal myxoma. Case report and review of the literature.Lo GG, Biswas J, Rao NA, Font RL. Cornea. 1990 Apr;9(2):174-8. Review

Solitary corneal myxoma.Pérez-Grossmann RA, Mesias LA, Contreras F, Spencer WH.Cornea. 1997 Jul;16(4):498-500

Primary corneal myxoma.Hansen LH, Prause JU, Ehlers N, Heegaard S. Acta Ophthalmol Scand. 2004 Apr;82(2):224-7. Review

Primary corneal myxoma.Soong T, Soong V, Salvi SM, Raynor M, Mudhar H S, Goel S, Edwards M. Cornea. 2008 Dec;27(10):1186-8