Giant cell collagenoma
bovine serum at 1%. The following antibodies were utilized: vimentine (BioGenex), cytokeratine (Bio- Genex), desmine (BioGenex), protein S-100 (Bio- Genex), CD34 (BioGenex) and CD68 (Dako). The lesion was diffusely positive for vimentine and only the giant cells were positive for CD68 but negative for cytokeratine, desmine, protein S-100 and CD34.
The diagnostic was giant cell collagenoma in bul- bar conjunctiva.
Giant cell collagenoma is an infrequent soft tis- sue tumor. It is believed it could originate in fibro- blastic cells. Rudolph (1) described this neoplasia within the fibroblastic soft tissue tumors, where the predominant morphological pattern is an intense deposit of hyalinized collagen matrix with a stori- form pattern and the presence of giant cells. The lat- ter criterion is not present in all of said tumors, and for this reason the nomenclature describes them as demoplastic fibroblastoma, collagenome fibroma, giant cell fibroblastoma, etc.
Cases of collagenous fibroma have been reported (desmoplastic fibroblastoma) (2,3) in different parts of the body, with the limbs being the area most fre- quently affected. Other areas include the neck, shoulder, parotide glands and feet. All patients exhibited a slow growing painless mass. The tumor occurs with the same frequency in both men and women.
Circumscribed storiform collagenome was first mentioned by Weary et al (4) 31 years ago in the context of Cowden’s disease and was considered as one of the main diagnostic criteria for the multiple hamartoma syndrome. Rapini and Golitz subse- quently reported a sporadic form with analogous shape, for which reason Metcalf (5).
Proposed describing it individually, designating it as circumscribed storiform collagenoma.
All the above mentioned tumors could belong to a group characterized by a collagenous matrix.
The morphology, the structural characteristics of the matrix with abundant collagen deposits and the presence of bizarre cells proves the striking simila- rity of the herein reported lesion with the tumor defined by Rudolph as «giant cell collagenoma».
The differential histological diagnostic includes several fibrous proliferations with multinucleated cells such as the pleomorphic fibroma, variants of dermato- fibroma, atypical fibroxantoma, giant cell fibroblasto- ma, nevus of Spitz, pleomorphic lipoma, reticulohis- tiocitoma, variants of xantomas or xantogranulomas and histiocytical inflammatory lesions such as foreign body reactions with keloid scar formation.
One point to be taken into account when the tumor is located in the eye is that the ophthalmolo- gical characteristics of the lesion, having a whitish nodulated appearance, hard to the touch and firmly adhered to surrounding tissues, can be interpreted as a neoplasia with malign behavior and lead to the- rapeutic errors.
In spite of the bizarre behavior of the giant cells, the absence of mitosis and the clinical evolution would confirm the benign nature of this neoplasic entity.
In summary, a conjunctiva giant cell collagenoma is presented. Additional papers describing a larger number of these tumors will allow for a better knowledge of this type of lesion.
Rudolph P, Schubert C, Harms D, Parwaresch R. Giant cell Collagenoma: a benign dermal tumor with distinctive multinucleate cells. Am J Surg Pathol 1998; 22: 557-563.
Evans HL. Desmoplastic fibroblastoma. A report of seven cases. Am J Surg Pathol 1995; 19: 1077-1081.
Nielsen GP, O’Connell JX, Dickersin GR, Rosenberg AE. Collagenous fibroma (desmoplastic fibroblastoma): a report of seven cases. Mod Pathol 1996; 9: 781-785.
Weary PE, Gorlin RJ, Gentry WC Jr, Comer JE, Greer KE. Multiple hamartoma syndrome (Cowden’s disease). Arch Dermathol 1972; 106: 682-690.
Metcalf JS, Maize JC, LeBoit PE. Circumscribed stori- form collagenoma (sclerosing fibroma). Am J Dermato- pathol 1991; 13:122-129.
ARCH SOC ESP OFTALMOL 2007; 82: 233-236