Corneal Pyogenic Granuloma: A Case Report And Systematic Review

To report a rare case of a corneal pyogenic granuloma that was temporally associated to limbal stem cell deficiency occurring after immunotherapy for breast cancer treatment. Furthermore, we present a systematic review characterize the rarity of corneal pyogenic granulomas, to analyze predisposing factors, and summarize the clinical signs, symptoms and outcomes associated with this condition.

Case report from a tertiary care center. Systematic review of English-language cases identified through medical science databases, specifically detailing corneal pyogenic granulomas.

Following PRIMSA guidelines, a systematic review of Web of Science, Scopus, Embase, PubMed, MEDLINE, and CINAHL was conducted using key terms “pyogenic granuloma” AND “cornea*”.Two reviewers independently screened primary English-language sources. Extracted data included patient demographics, ocular and medical history, lesion characteristics, treatment modalities, and clinical outcomes. Descriptive statistics were utilized for analysis.

The systematic review identified 15 articles describing 30 patients. Most patients (86.7%) had a contributory ocular history, primarily glaucoma, prior ocular surgery, or trauma. Lesions were predominantly central. The average lesion average area was 17.3 mm². Corneal pyogenic granulomas were associated with profound visual impairment; 11 of 15 patients had visual acuity of counting fingers or worse. Surgical excision was the primary treatment (80.0%). Despite epithelial healing in many cases, visual outcomes were often poor, and recurrence occurred in four patients (13.3%).

Corneal pyogenic granulomas are rare and typically arise in eyes with preexisting corneal vascularization from prior injury, surgery, or chronic irritation. While surgical excision is the mainstay of treatment, visual recovery is often limited by residual scarring. This report describes the first case of corneal pyogenic granuloma that was temporally associated with limbal stem cell deficiency that occurred after immunotherapy for a distant cancer, suggesting a potential novel contributing factor for the development of a corneal pyogenic granuloma.