The meibomian gland adenocarcinoma is very rare and lethal tumor of the eyelid. The upper eyelid is more often affected than the lower eyelid. Clinical feature of this tumor is that it may masquerade as a chalazion or chronic blepharoconjunctivitis for many months before the true diagnosis is established. Treatment of the consists of surgical removal and radiation therapy. The authors have experienced a case of meibomian gland adenocarcinoma which had recurred after two chalazion surgeries at a local clinic in the left lower eyelid of a 61-year-old korean female. The tumor was excised surgically with reconstruction of the lid defect by modified Hughes procedure and was found to be a adenocarcinoma of the meibomian gland histopathologically.
Adenocarcinoma* ; Chalazion ; Diagnosis ; Eyelids ; Female ; Humans ; Meibomian Glands* ; Middle Aged

PURPOSE: Paraffinoma is a granulomatous reaction to paraffin or oily substances. We report delayed diagnosis of paraffinoma that was misdiagnosed as chalazion. CASE SUMMARY: A 49-year-old male presented with masses, swelling, and erythema in the right lower eyelid, masses and swelling in the right upper eyelid, and intermittent conjunctival injection that had appeared 3 months ago. The patient admitted having received paraffin injection to the right lateral canthal area and nasal bridge for cosmetic purposes by non-medical personnel 17 years prior to presentation. The mass showed partial response to intralesional triamcinolone injection but did not respond to systemic steroid. CONCLUSIONS: Paraffinoma can present diagnostic confusion given its protracted latency period and discordance of injection area and mass location. Detailed history taking is required and the possibility of paraffinoma should be considered for mass lesions of the eyelid.
Chalazion* ; Delayed Diagnosis ; Erythema ; Eyelids* ; Humans ; Latency Period (Psychology) ; Male ; Middle Aged ; Paraffin ; Triamcinolone

To investigate the present status with its side effect of ocular tatooing for cosmetic purpose in our country, 150 patients with the eyelid and eyebrow tatooing who visited my clinic from July 1986 to October 1988 were enrolled in this study. Six patients who complained the early complications after the cosmetic tatooing were included in the tatooing group, and 150 patients without the tatooing were used as a control group for the statistical study. The following results were obtained: 1. The ages tatooed ranged from 19 to 68 years old age with the mean age of 39.65 +/- 9.46 years. Fourth and fifth decades consited of 76% of the total subjects tatooed. 2. At their first visit, blepharitis, external hordeolum, pingueculitis, subconjunctival hemorrhage and keratitis were more statistically frequent than the control gruop(p<0.05), but chalazion was not so. 3. Cosmetic tatooing was gradually noted after 1984 and was most frequently performed in 1986(41%). Thereafter, it reduced from 1987(35%) until now. 4. One half was tatooed once and 1 to 3 times of tatooing were added for the remainder. 5. Ninetyseven % of tatooing was done by non-medical doctor in beauty parlor or the other places excluding the hospital, and only 3% was performed by medical doctor in the hospital. 6. Eyelid tatiooing was noted in 96% of the total subjects tatooed and eyebrow tatooing was shown in over half of them(53%). 7. Early complication of the tatooing was confirmed by history taking in 29% of the total subjects tatooed, which consited of lid swelling(23%), subcutaneous hemorrhage of lid(4%), itching sensation(2%) and conjunctival redness(1%). Clinical Observations on Cosmetic Ocular Tatooing Six patients were treated for one to 10 days for the early complication of tatooing under the diagnosis of lid edema(100%), keratitis(83%), subcutaneous hemorrhage of lid(50%), blepharititis(33%), conjunctivitis(33%), corneal abrasion(33%) and conjunctival foreign body(17%). 8. Thirtysix % out of the patients confirmed by history taking was regretful after the cosmetic tatooing.
Aged ; Beauty ; Blepharitis ; Chalazion ; Diagnosis ; Eyebrows ; Eyelids ; Hemorrhage ; Hordeolum ; Humans ; Keratitis ; Pruritus ; Statistics as Topic

PURPOSE: To report a rare case of sebaceoma misdiagnosed as chalazion. CASE SUMMARY: A 42-year-old female presented with a visible mass in her right lower eyelid. An elevated, hard mass was located at the margin of the right lower eyelid, and she had a history of incision and curettage under the clinical impression of chalazion. On eversion of the lower eyelid, the tarsal portion of the mass was visible as a white-yellowish lesion. The mass was excised under local anesthesia. A sebaceoma was diagnosed based on histopathological examinations. Immunohistochemical studies showed positive staining results for mutator L homologue 1 (MLH1), mutator S homologue 2 (MSH2), and mutator S homologue 6 (MSH6), and she had no past medical history or family history of internal malignancy, suggesting a low possibility of Muir-Torre syndrome. CONCLUSIONS: Eyelid sebaceoma should be considered as a differential diagnosis for refractory chalazion.
Adult ; Anesthesia, Local ; Chalazion* ; Curettage ; Diagnosis, Differential ; Eyelids* ; Female ; Humans ; Muir-Torre Syndrome

A 23-year-old woman visited our clinic for the evaluation of a small bean-sized mass in the right lower eyelid. She noticed a mass in the right lower eyelid 6 years ago. The mass was treated with incision and curettage under the impression of chalazion twice at the local clinic, but recurred soon after the operation. On examination, the visual acuity was 1.0 in both eyes. A firm, non-tender, smooth, movable and small bean-sized mass was palpable in the right lower eyelid. A white scar from the previous operation was seen on the palpebral conjunctiva of the right lower eyelid. The mass was excised through the conjunctiva. The histopathological diagnosis of the excised mass was benign mixed tumor. The patient was recommended of further radical excision. The pentagon-shaped excision of the right lower eyelid under frozen section control was done 2 weeks after the first operation. The patient is doing well as of now. The benign mixed tumor of the lower eyelid can arise from either ectopic lacrimal gland or accessory lacrimal gland.
Chalazion ; Cicatrix ; Conjunctiva ; Curettage ; Diagnosis ; Eyelids* ; Female ; Frozen Sections ; Humans ; Lacrimal Apparatus ; Visual Acuity ; Young Adult

PURPOSE: We report a case of the granulocytic sarcoma located at the conjunctival fornix in a 10-year-old girl with acute myeloid leukemia, who was in complete remission after bone marrow transplantation. METHODS: A 10-year-old girl had a 1-week history of firm, dark brown conjunctival mass at lower fornix and mild lid swelling of the right eye. Several months previously she had had some chalazions at lower lid and a history of acute myeloid leukemia that was currently in complete remission after bone marrow transplantation. Other ocular manifestations were not specific. Excision of the conjunctival mass and a biopsy for diagnostic and therapeutic purposes were performed. RESULTS: The 12 x 6 x 5 mm-sized mass was totally excised. The pathologic examination was consistent with granulocytic sarcoma. Three weeks after the biopsy, the patient had a relapse of acute myeloid leukemia. She died 2 months later while undergoing intensive therapy. CONCLUSIONS: This condition should be considered in the diagnosis of granulocytic sarcoma in patients with a history of acute myeloid leukemia.
Biopsy ; Bone Marrow Transplantation ; Chalazion ; Child ; Conjunctiva* ; Diagnosis ; Female ; Humans ; Leukemia, Myeloid, Acute ; Recurrence ; Sarcoma, Myeloid*

PURPOSE: To report the first case of a solitary eyelid fibrofolliculoma and to review the literature. METHODS: A 37-year-old female patient visited the outpatient department with a lesion in the right upper lid that had been growing steadily for a year. The patient had visited the local clinic, and under the diagnosis of chalazion had received incision and curettage twice, but the lesion had recurred. RESULTS: The 5 x 5 mm lesion was located near the upper lid margin. It was a red, hemispheric, smooth nodule, relatively solid to palpation and not painful. Excision and biopsy were performed, and through a histological exam, the diagnosis of fibrofolliculoma was later confirmed. CONCLUSIONS: Solitary fibrofolliculoma is rare, and to the authors' knowledge, a lesion arising in the eyelid has not yet been reported. Fibrofolliculoma should be included in the differential diagnosis when a localized mass lesion arising in the eyelid is encountered.
Adult ; Chalazion/*diagnosis ; Diagnosis, Differential ; Eyelid Neoplasms/*diagnosis/pathology/surgery ; Female ; Fibroma/*diagnosis/pathology/surgery ; Humans ; Ophthalmologic Surgical Procedures

PURPOSE: To report a rare case of upper eyelid schwannoma presenting as a chalazion. CASE SUMMARY: A 54-year-old male presented to our clinic with a slowly growing, painless recurred mass located in the middle area of the right upper eyelid margin. Surgical incision had been performed on a similar mass two year previous, although no histological analysis had been performed. On examination, a 4 × 3-mm-sized, firm, nonpigmented mass was palpable in the right upper eyelid, and no signs of neurofibromatosis were present elsewhere. The lesion was initially thought to be an eyelid mass, so we performed an excisional biopsy under local anesthesia. The lesion was easily isolated from the surrounding tissue and was excised completely. Histopathologically, the excised mass showed a compact arrangement of spindle cells forming palisades with Verocay bodies (Antoni A patterns). Immunohistochemistry revealed diffuse and strong S-100 protein positivity. These findings resulted in the diagnosis of eyelid schwannoma. CONCLUSIONS: Because of its rarity and solitary feature, eyelid schwannoma can be confused with chalazion. Thus, ophthalmologists should consider schwannoma in the differential diagnosis of a slowly growing, painless recurred mass or a lesion with malignant transformation after incomplete excision.
Anesthesia, Local ; Biopsy ; Chalazion ; Diagnosis ; Diagnosis, Differential ; Eyelids* ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neurilemmoma* ; Neurofibromatoses ; S100 Proteins

PURPOSE: We report a case of rhabdomyosarcoma misdiagnosed as a chalazion. METHODS: 11-year-old boy, complaining of tumoral lesion on his left upper eyelid that was suspected to be a chalazion, visited our clinic with progressed lid swelling and edema. The mass lesion was removed surgically, and demonstrated a well-demarcated solid mass of 2 X 2cm in diameter within the medial part the left upper lid. Histopathologic examination showed infiltrative, small round cells and he was diagnosed with embryonal type rhabdomyosarcoma by the positive responses of Desmin, SMA and Ki-67 on immunohistochemical study. Following diagnosis as IRS group IIA because the adjacent fatty tissues were involved with the tumor cells, radiotherapy and chemotherapy were done. RESULTS: After chemotherapy for 47 weeks and radiotherapy for 4 weeks, the patient had only mild signs of keratitis and there was no evidence of the tumor in his left upper lid throughout 12 months of follow-up. CONCLUSIONS: We experienced a case of rhabdomyosarcoma misdiagnosed as a chalazion that was successfully treated by surgical excision, radiotherapy and chemotherapy. Because the presenting signs and symptoms of orbital rhabdomyosarcoma sometimes show a misleading variety including chalazion, the physician should consider the possibility of a rhabdomyosarcoma in any recent onset of rapidly progressing mass of the lid in childhood.
Chalazion* ; Child ; Desmin ; Diagnosis ; Drug Therapy ; Edema ; Eyelids ; Follow-Up Studies ; Humans ; Keratitis ; Male ; Orbit ; Radiotherapy ; Rhabdomyosarcoma*

Sebaceous carcinoma of meibomian gland is not so common as is generally re ported. In general feature of this tumor may masquerade as a chronic blepharoconjunctivitis or a chalazion for many months before the true diagnosis is esta blished. In the case of orbital involvement secondarily the patient may occasion ally develop as solid nodule in the fossa of the lacrimal gland that may simulate a primary gland tumor, The authors experienced one case of sebaceous carcinoma which developed in the orbital area. This was a 23-rear-old female who had a growing large mass in the left orbital area, which caused proptosis and decreased vision. Computed tomography of the left orbit demonstrated a large soft tissue mass lesion, about 3 X 3 X 1.5 cm in size, in superotemporal side of the retroorbital portion. The patient underwent a lateral orbitotomy and excisional biopsy of the tumor. Microscopic examination showed intracytoplasmic lipoid vacuoles and mixed pattern which was an admixture of lobular and comedocarcinoma-like area. About 2 months later the tumor recurred, so subtotal orbital exenteration with preservation of lid, conjunctiva, cornea and sclera was undertaken and radiotherapy was taken. However, this tumor was extended to brain.
Biopsy ; Brain ; Chalazion ; Conjunctiva ; Cornea ; Diagnosis ; Exophthalmos ; Female ; Humans ; Lacrimal Apparatus ; Meibomian Glands ; Orbit ; Radiotherapy ; Sclera ; Vacuoles