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Juvenile Xanthogranuloma Presenting as Infiltrative Conjunctival Mass in an Adult

Purpose To report on the clinical and histopathologic findings of a conjunctival juvenile xanthogranuloma in an adult. Methods Case report and literature review. Results A 43-year-old man developed 2 yellowish conjunctival lumps not associated with other ocular or systemic findings. A half-corneal diameter–sized main mass was located at the 2-o'clock position, and the other 1/8-corneal diameter–sized mass was located at the 4-o'clock position. The masses were vitelliform in appearance with poor supplying vessels. The masses were removed en bloc by conjunctivectomy. Cryotherapy was done along the excision margin. Histopathologic examination revealed dense infiltration by histiocytes with background of multiple lymphocytes and Touton giant cells. Immunohistochemical staining was positive for CD3 (T-cell marker) and CD68 (histiocytic marker) but negative for CD1a and S-100 (Langerhans cell marker). Conclusion Juvenile xanthogranuloma may present as conjunctival infiltrative masses in adults. Immunophenotyping is helpful in differentiating it from a more malignant lesion.