A RARE CASE REPORT OF GLOMUS TUMOUR OVER MARGIN OF LOWER LID OF LEFT EYE

Introduction: Glomus tumours are rare, benign tumours of vascular origin, arising from the glomus body. Glomus tumours are neoplasms of mesenchyme derived from glomus bodies. Glomus tumours present as a purple or pink vascular lesion that can be confused with a vascular neoplasm such as hemangioma. In this case we are reporting a rare presentation of glomus tumour over lower lid. A 10 year old female child presented with lesion over left lower Case Report: lid since 3 months which was painless and progressive. On examination a 0.3x0.3 cm subcutaneous pink non encapsulated mass is seen over medial canthus of left eye. Mass was excised and subjected to histopathological examination which confirmed the diagnosis of glomus cell tumour(glomangioma). Postoperative period was uneventful with no recurrence for last 6months. Conclusion: All excised eyelid lesions should undergo detailed Histopathological evaluation and glomus tumour should be considered as one of the differential diagnosis in patients presenting with eyelid mass

Superficial Angiomyxoma of the Eyelid. A Case Report and Review of the Literature

@#Superficial angiomyxoma (SA) is an angiomyxoid cutaneous tumour. It has predilection for the head and neck, torso, limbs and genital tract. Our case is a 27-year-old female, presented with painless right medial canthal mass for two years. It was associated with tearing when the lesion grew larger. We received a nodular brownish tissue measuring 25x20x15mm with homogenous brownish cut surface. Microscopically, the tumour was partially circumscribed, exhibiting bland stellate to spindle cells of moderate cellularity with pale eosinophilic cytoplasm, indistinct border, in a loose collagenous myxoid matrix with numerous blood vessels of different calibre. The lesional cells were present at the resected margin and were nonreactive towards CD34, SMA and S100. SA of the eyelid is sometimes mistaken clinically as dermoid cyst or lipoma. Reports have shown increased risks of local recurrence following incomplete excision. Close association with Carney’s complex is an important feature. Careful clinicopathologic correlation and proper investigations are needed for optimal patient care.

A Case of Primary Mucinous Adenocarcinoma of the Lower Eyelid

PURPOSE: To report a rare case of a recurrent painless mass of the right lower eyelid, which was histologically diagnosed as a mucinous adenocarcinoma. CASE SUMMARY: A 59-year-old male had a painless nodule on the right lower eyelid for 2 years. He had a history of five laser treatments done by a dermatologist prior to the initial presentation. Surgical shave biopsy was performed and a histopathological examination revealed a mucinous adenocarcinoma. We subsequently performed a pentagonal excision of the lower eyelid with assisted frozen biopsy until no tumor cells were seen at the margin. A postoperative whole-body positron emission tomography scan, chest computerized tomography, gastrointestinal endoscopy, and colonoscopy excluded systemic metastases. No recurrence has been observed for 18 months after the surgery. CONCLUSIONS: Primary mucinous adenocarcinoma is a rare disorder of the eyelid. Because it has various morphologies, and the final diagnosis can only be made by histopathological examination. If there is a recurrent mass at the eyelid margin, adenocarcinoma should be considered as the differential diagnosis. A complete surgical excision is recommended to prevent local recurrence.

Upper eyelid lipogranuloma following facial autologous fat injection: A retrospective study of 8 cases / 中华医学美学美容杂志

Objective To investigate clinical characteristics and treatment of upper eyelid lipogranuloma cases that developed after facial autologous fat injection.Methods This retrospective study involved 8 patients who presented with upper eyelids symptoms (final diagnosis of lipogranulo ma) and had history of facial autologous fat injection.The collected data included information on patient sex,age,clinical presentation,laboratory findings,treatment and outcome.Results All 8 cases were managed by exploration and surgical removal through double eyelid surgery.All patients showed complete resolution over 1-12 months follow up period.Conclusions Lipogranuloma can develop in the upper eyelid after autologous fat injection into the face.and surgical removal can yield satisfactory outcomes in cases of repeated failure of conservative therapies.

Eyelid Mass as Initial Presentation of Breast Cancer: A Case Report

PURPOSE: We report a case in which eyelid mass was the initial presentation of breast cancer. The diagnosis of breast cancer was made after lid biopsy. CASE SUMMARY: A 41-year-old female patient presented with a painful mass on the left lower lid after 1 month. There was a pinkish mass in the lateral portion of the tarsal conjunctiva, and computed tomography revealed a mass with an irregular margin on the lower lid connected to the left lacrimal gland. Biopsy was performed at the tarsal conjunctiva of the left eye, and histopathologic examination was suggestive of malignant epithelial cell neoplasm, especially metastatic carcinoma in the breast. The patient was diagnosed as having invasive ductal cancer, for which she is currently receiving chemotherapy. CONCLUSIONS: Metastases to the eyelid are very rare, accounting for less than 1% of all malignant eyelid lesions. We report a patient who presented with an eyelid mass as the initial presentation of breast cancer, which was diagnosed with metastatic breast cancer.

Fibroepithelial Polyp on the Eyelid Margin: A Case Report

PURPOSE: Fibroepithelial polyps on the eyelid or orbit have not been previously reported in Korea. Herein, we report our experience with a case of a primary localized fibroepithelial polyp of the eyelid. CASE SUMMARY: A 78-year-old male patient presented with a round mass on the lower eyelid which has been noticed 1 week prior. There was no pain and no tenderness. The mass was removed and excisional biopsy was performed. Histopathologic examination revealed findings suggestive of a fibroepithelial polyp. There was no local recurrence during 4 months of follow-up. CONCLUSIONS: Fibroepithelial polyp should be considered when determining the type of eyelid mass.

Solitary Neurofibroma Occurred on the Eyelid Margin without Neurofibromatosis: A Case Report

PURPOSE: We report a rare case of solitary neurofibroma on the eyelid margin without neurofibromatosis. CASE SUMMARY: A 46-year-old male presented with a well-define small nodular lesion on the right upper eyelid margin that had not changed for 10 years. Surgical excision and biopsy were performed. Histological examination showed spindle-shaped cells in the fibrous stroma on hematoxylin & eosin staining, and immunohistochemical staining revealed S-100 protein-positive cells. Dermatologic, neurologic, and genetic evaluations showed no evidence of systemic neurofibromatosis. Six months after operation, there was no evidence of local recurrence. CONCLUSIONS: To the best of our knowledge, this is the first case of solitary neurofibroma involving the eyelid margin without neurofibromatosis in Korea. Neurofibroma should be considered in a differential diagnosis of eyelid mass and can be successfully managed with surgical excision.

Three Cases of Periorbital Nodular Fasciitis

PURPOSE: Herein, we report 3 cases of nodular fasciitis presenting with periorbital mass. CASE SUMMARY: An 18-year-old male presented with a mass in his left lateral temple area 3 months in duration. On physical examination, a subcutaneous mass approximately 20 mm in size was palpable with upper eyelid swelling. Orbital magnetic resonance imaging (MRI) showed T1 isointensity and T2 hyper intensity and a well-circumscribed enhancing lesion. A 36-year-old male presented with a 6-month history of a bump under his right upper eyelid. External examination revealed a 15 mm-sized subcutaneous mass in the right central sub-brow area. Orbital computed tomography showed a homogenous, well-circumscribed mass with moderate enhancement. A 3-year-old boy presented with a mass in his right upper eyelid 4 months in duration. A subcutaneous mass approximately 10 mm in size was palpated at the medial superior orbital rim. Orbital MRI revealed an enhanced mass of irregular shape. Surgical excision was performed for all cases. Histopathological examination showed pathognomonic proliferation of spindle cells and immunohistochemical stains showed the spindle cells were positive for smooth muscle actin, negative for S-100 and negative for CD34, consistent with nodular fasciitis. Recurrence of the tumors after excision in the 3 cases was not observed after 4 months, 3 months and 48 months, respectively. CONCLUSIONS: Nodular fasciitis is rare but can occur at the periorbital region. In particular, nodular fasciitis should be considered as a differential diagnosis of a subcutaneous mass short in duration in children or young adults.

Folliculosebaceous Cystic Hamartoma of the Eyelid

PURPOSE: Folliculosebaceous cystic hamartoma is a rare cutaneous hamartoma consisting of dilated folliculosebaceous units invested in mesenchymal elements. There is no report of folliculosebaceous cystic hamartoma case occurred in the eyelid. We report here on this case along with a review of the relevant literature. CASE SUMMARY: 72-year-old female visited for the complaint of a mass in right upper eyelid. The mass was 1.9 × 1.2 cm sized and palpated in the subcutaneous level of right upper eyelid. The mass was not tender and had hardness like rubber. It was covered by skin without adhesion but fixed on the upper tarsal plate. Turning the eyelid inside out, it was found that the upper tarsal plate was penetrated by the mass. There was no specific finding except both cataract by other ophthalmic examination. The paranasal sinus computed tomography finding was well demarcated 0.9 cm sized mass with calcification. The excisional biopsy was performed for diagnosis and treatment. In pathologic finding, various sized normal sebaceous lobules were connected with the dilated follicles through the sebaceous canal and formed infundibular structure. There were sclerosing collagen, adipose cells and vessels between follicles and sebaceous lobules. So it was compatible with folliculosebaceous cystic hamartoma. 18 months later, there was no recurrence and wound was clear. CONCLUSIONS: Folliculosebaceous cystic hamartoma of the eye lid is rare disease, and differential diagnosis is necessary in patient with mass of eyelid.

Primary Systemic Amyloidosis of the Eyelid: A Case Report

PURPOSE: Amyloidosis involving the eyelid is a rare condition. We report a case of primary systemic amyloidosis of the eyelid. CASE SUMMARY: A 26-year-old female presented with multiple nodules on the bilateral upper and lower eyelids that had stopped growing several years prior. Multiple pearl-colored small nodular lesions were present on the upper and lower eyelid bilaterally and no clinically specific signs were observed. Surgical excision, biopsy and electrocauterization were performed. Histological examination showed amorphous and eosinophilic substances on hematoxylin & eosin (H&E) staining and orange-colored amyloid deposits stained with Congo-red. Systemic evaluation showed amyloid nodules invading the vocal cords and external auditory canal, therefore the patient was diagnosed with primary systemic amylodosis. At the postoperative 6-month follow-up, recurrence or inflammation at the operation site was not observed. CONCLUSIONS: To the best of our knowledge, this is the first case of primary systemic amyloidosis of the eyelid in Korea. Amyloidosis should be considered in a differential diagnosis of a mass in the eyelid and can be successfully managed with surgical excision and electrocauterization.

A Case of Eccrine Spiradenoma of the Eyelid

PURPOSE: To report a case of eccrine spiradenoma that presented as an eyelid nodule. CASE SUMMARY: A 61-year-old female presented with a mass in the right upper lid margin; the onset time was unknown. An ophthalmic examination revealed no abnormalities except the eyelid nodule. The nodule was 3 mm in size with a firm, smooth surface and light pinkish color, and was located near the lid margin. Excision and biopsy of the nodule was performed. The pathological findings of the specimen obtained showed islands of 2 types of lobular cells. Larger, paler cells were grouped around the central area, darker and smaller cells on the periphery. These findings were compatible with eccrine spiradenoma. CONCLUSIONS: Eccrine spiradenoma should be considered a differential diagnosis of a solitary eyelid tumor.

A Case of Apocrine Adenocarcinoma of the Upper Eyelid

PURPOSE: To report a case involving an eyelid mass that was diagnosed as apocrine carcinoma. CASE SUMMARY: A 52-year-old man visited our hospital with a recurrent mass on his right upper eyelid, which had developed 4 years prior. Initially, he received laser therapy at a dermatologic clinic to remove the mass. Two years later, the mass recurred and was excised at another clinic. At the time the patient visited our institution, the lesion had developed into multiple erythematous nodules at the margin of the right upper eyelid. The results of excisional biopsy performed under local anesthesia revealed hidradenoma papilliferum. One month after excision, recurred multiple elevated nodules were found at the margin of the excision, and thus total excision of the mass and reconstruction of the upper eyelid was performed. Biopsy confirmed that the mass was apocrine adenocarcinoma. Five months have passed since the excision and no evidence of recurrence has been observed. CONCLUSIONS: Apocrine adenocarcinoma is a malignant tumor of the sweat gland and is rarely found on the eyelid. Apocrine adenocarcinoma should be considered in the differential diagnosis of recurrent eyelid mass at the eyelid margin.

A Case of Multiple Eyelid Trichilemmoma Associated with Cowden Syndrome

PURPOSE: To report a case of multiple eyelid trichilemmomas associated with Cowden syndrome. CASE SUMMARY: A 27-year-old woman presented with multiple upper and lower eyelid skin masses that developed over several years. The masses were as large as whitish millet, and were around the upper and lower eyelid margin and the face. The patient had previously undergone subtotal thyroidectomy for a thyroid mass and a mass excision for extremity hemangioma. Excisional biopsy was performed for the diagnosis, and trichilemmoma was diagnosed based on histopathologic examination. Consequently, multiple trichilemmoma associated with Cowden syndrome was diagnosed, and breast evaluations for existence of further masses were recommended. On breast examinations, intraductal papilloma and fibroadenoma were detected. CONCLUSIONS: The trichilemmoma was a hair-follicle benign tumor that also appeared on the skin around the eyelid. If multiple trichilemmoma is diagnosed, an association with Cowden syndrome should be considered as well as presence of masses in other organs.

A Case of Pleomorphic Adenoma Arising in the Ectopic Lacrimal Gland of the Lower Eyelid

PURPOSE: To report a case of pleomorphic adenoma arising in the ectopic lacrimal gland of the lower eyelid. CASE SUMMARY: A 36-year-old male presented with a gradually increasing mass in the left lower eyelid that had been growing for one year. A hard, non-tender, subcutaneous mass was palpated on the lateral one-third of the left lower eyelid, and there were no clinically specific signs. Orbital computed tomography demonstrated a well-demarcated 1 x 0.7 x 0.7-cm-sized mass with heterogeneous enhancement, and complete surgical resection was performed. The mass was non-adjacent to the conjunctiva and inferior tarsal plate. Histological examination showed glandular elements embedded in a myxoid stroma. The mass was diagnosed as pleomorphic adenoma arising in the ectopic lacrimal gland. At the postoperative 6-month follow-up, there was no recurrence or abnormal finding at the operation site. CONCLUSIONS: Pleomorphic adenoma arising in the ectopic lacrimal gland should be considered as a differential diagnosis of eyelid masses.

A Case of Syringocystadenoma Papilliferum of the Eyelid

PURPOSE: To report a case of syringocystadenoma papilliferum that presented as an eyelid nodule. CASE SUMMARY: A 37-year-old woman presented with a mass around the punctum in the right lower eyelid margin, which had developed several years earlier and was increasing in size. The mass was a light pinkish nodule consisting of a few smooth-surface papillary lobules. The pathologic findings of the specimen obtained from a shaving biopsy showed a papillary projection which was covered with epithelium and communication with duct-like structures showing glandular configuration in the deep portion of the lesion. EMA-positive cells were found at the invaginated epithelium, implying a glandular epithelial origin. GCDFP-15-positive cells were found in the deep portion of the lesion, implying apocrine differentiation. The findings were compatible with syringocystadenoma papilliferum. CONCLUSIONS: Syringocystadenoma papilliferum should be considered as a differential diagnosis of a solitary eyelid tumor.

A Case of Localized Merkel Cell Carcinoma on the Upper Eyelid

PURPOSE: To report a case of Merkel cell carcinoma on the left upper eyelid without metastasis and its immunohistochemical features. The carcinoma was successfully treated with excisional surgery and prophylactic radiation therapy. CASE SUMMARY: A 76-year-old woman presented to the hospital complaining of a 0.6 x 0.9-cm-sized painless and purplish-red colored mass that had grown rapidly on her left upper eyelid margin over the previous two months. An excisional biopsy was performed. On immunohistochemical examination of the lesion, the tumor cells expressed immunoreactivity for synaptophysin and were negative for LAC and cytokeratin, confirming the diagnosis of Merkel cell carcinoma. Additional surgery was performed because the surgical margins were positive. No other primary or metastatic lesions were found. The patient was treated with local prophylactic irradiation and remained disease-free at her 10-month follow-up visit.

A Case of Angiolymphoid Hyperplasia with Eosinophilia (ALHE) of the Eyelid

PURPOSE: The authors of the present study describe a rare case of angiolymphoid hyperplasia with eosinophilia (ALHE) of the eyelid. CASE SUMMARY: A 63-year-old male who was diagnosed with ALHE based on biopsy of an inguinal mass presented with an eyelid mass of 1 month duration. A light brown, solitary, 1.0 x 0.5 cm-sized mass involved the right upper eyelid. There was no lymphadenopathy, but eosinophilia was present. An excisional biopsy of the mass was performed for diagnosis and management. Macroscopic examination of the excised mass revealed a well-defined, smooth, firm, yellowish-red colored lesion measuring 1.0 x 0.6 x 0.5 cm. Histopathology showed the proliferation of small blood vessels, many of which were lined by enlarged endothelial cells with uniform ovoid nuclei and intracytoplasmic vacuoles. The distinctive endothelial cells were described as having a cobblestone appearance. In addition, a perivascular and interstitial infiltrate composed primarily of lymphocytes and eosinophils was present. ALHE was finally confirmed with clinical and microscopic examination. CONCLUSIONS: The authors of the present study report a rare case of ALHE of the eyelid and suggest that a differential diagnosis should be considered.

A Case of Chondroid Syringoma Involving the Eyelid Margin

PURPOSE: To report a case of chondroid syringoma that involved the eyelid margin, was accompanied by cilia loss, and required differential diagnosis with other malignant eyelid masses. CASE SUMMARY: A 46-year-old woman presented with a recurrent mass in the right lower eyelid margin, which was observed 10 years earlier, where incision and curettage had already been performed twice. The mass was neither tender nor ulcerated, was brighter in color than the neighboring skin, and had a smooth surface with cilia loss. The pathologic findings obtained from an incisional biopsy were compatible with a dermoid cyst. Full-thickness excision of the eyelid mass and direct closure were subsequently performed. The pathologic diagnosis after excisional biopsy was chondroid syringoma because cystic structures in the chondroid stroma were observed.

A Case of Nodular Fasciitis in the Upper Eyelid

PURPOSE: To report a rare case of nodular fasciitis in the upper eyelid. CASE SUMMARY: A 42-year-old woman presented with rapid enlarging mass, 15x12 mm in size at left upper eyelid. Orbit CT disclosed an enhanced, well-circumscribed preseptal lid mass. The histopathologic and immunohistochemical analyses after excisional biopsy were consistent with nodular fasciitis. There was no recurrence of the tumor after excision. CONCLUSIONS: For rapidly enlarging lid mass, nodular fasciitis should be considered as a differential diagnosis of sarcoma.

Sarcoidosis, Presented as Recurrent Eyelid Masses

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.