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: 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

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

PURPOSE: To report a patient presenting with an intratarsal keratinous cyst of the Meibomian gland in the upper eyelid and a review of the relevant literature. CASE SUMMARY: A 65-year-old male presented with a right upper eyelid mass which started 5 months prior. The patient reported that the mass recurred several weeks prior even after incision and curettage procedure. The mass was 9 x 5 mm in size and located in the center of the right upper eyelid at the level of lid crease, fixed to the tarsus and a whitish elevated focus was observed at the palpebral conjunctival surface. The mass was excised under local anesthesia and originated from the tarsus. The histopathological examinations revealed an intratarsal keratinous cyst composed of stratified squamous epithelium without keratohyalin granules and filled with keratin. The immunohistochemical studies showed positive staining results for cytokeratin 5/6, epithelial membrane antigen, and carcinoembryonic antigen. CONCLUSIONS: Intratarsal keratinous cyst of the Meibomian gland should be considered as a differential diagnosis of a recurrent tarsal mass.
Aged ; Anesthesia, Local ; Ankle ; Carcinoembryonic Antigen ; Chalazion ; Curettage ; Diagnosis, Differential ; Epidermal Cyst ; Epithelium ; Eyelids ; Humans ; Keratins ; Male ; Meibomian Glands* ; Mucin-1

PURPOSE: Organizing hematomas (hematic pseudocysts) of the orbit are usually the consequence of direct blunt trauma and are important in the differential diagnosis of orbital cystic lesion. Herein, we report a case of orbital organizing hematoma masquerading as a chalazion. CASE SUMMARY: A 12-year-old female visited our clinic complaining of left lower eyelid swelling. CT scan and MR imaging showed a mass detected in the inferomedial space of her left orbit, which did not invade the adjacent tissue. Excisional biopsy of the orbital mass was performed. Histological examination showed the accumulation of blood-breakdown products within a thick fibrous capsule without epithelial or endothelial lining. The mass was diagnosed as an organizing hematoma. CONCLUSIONS: An orbital organizing hematoma can present, although rare, as a chalazion-like eyelid mass. Careful clinical and radiological examinations can help in making a differential diagnosis.
Biopsy ; Chalazion* ; Child ; Diagnosis, Differential ; Eyelids ; Female ; Hematoma* ; Humans ; Magnetic Resonance Imaging ; Orbit* ; Tomography, X-Ray Computed

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: 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: Sarcoidosis is a granulomatous inflammation that can affect all organs, and the initial manifestation is sometimes ophthalmologic disease. The purpose of this article is to report the diagnosis of ocular sarcoidosis for a patient whose chief complaint was recurrent eyelid mass without any other ophthalmologic symptoms or signs. METHODS: A 43-year-old female had an 8-month history of bilateral upper eyelid swelling, right upper eyelid mass, and right ptosis. She had received localized steroid injection at a local dermatologic clinic. On physical examination, there were hard and fixed eyelid masses and mechanical ptosis due to an eyelid mass in the right upper eyelid. Mass excision and biopsy were performed, and a pulmonology specialist was consulted to evaluate the nodule on chest X-ray RESULTS: The patient's condition had been diagnosed with multiple chalazia at the first pathologic reading, but it was diagnosed with sarcoidosis at the second pathologic reading, which was requested because of recurrence. The diagnosis of sarcoidosis was based on chest PA, and chest CT, and was confirmed by lung biopsy specimen. CONCLUSIONS: In the case of recurrent eyelid mass, sarcoidosis should first be ruled out.
Adult ; Biopsy ; Chalazion ; Diagnosis ; Eyelids* ; Female ; Humans ; Inflammation ; Lung ; Physical Examination ; Pulmonary Medicine ; Recurrence ; Sarcoidosis* ; Specialization ; Thorax ; Tomography, X-Ray Computed

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*

Malignant tumors of the eyelid pose a serious threat because of their proximity to the globe, brain & paranasal sinuses. Three types of carcinomas account for the vast majority of the malignant eyelid tumors: basal cell carcinoma, squamous cell carcinoma, and sebaceous gland carcinoma. In these malignancies, basal cell carcinoma is the most common. However, sebaceous gland carcinoma has a high recurrence rate and a moderately high 5-year mortality rate because of late diagnosis and incomplete surgical removal. This tumor may be clinically misdiagnosed frequently as a chronic unilateral conjunctivitis, chalazion, basal cell carcinoma, or squamous cell carcinoma in initial biopsy. Suspicious lid lesions should be managed with incisional biopsy initially. If they are positive for sebaceous gland carcinoma, wide excision and frozen section monitoring of surgical margin is the treatment of choice. The final diagnosis should be confirmed by special stain for lipid. We experienced 12 cases of malignant eyelid tumors including 3 cases of sebaceous gland carcinoma. In cases of sebaceous gland carcinoma, wide surgical excision with frozen section monitoring was performed and followed by eyelid reconstruction with intact eyelid tissue remained and adjuvant radiotheraphy. Guidelines for management are discussed.
Biopsy ; Brain ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Chalazion ; Conjunctivitis ; Delayed Diagnosis ; Diagnosis ; Eyelids* ; Frozen Sections ; Mortality ; Paranasal Sinuses ; Recurrence ; Sebaceous Glands