A Case of Rhabdomyosarcoma Misdiagnosed as a Chalazion

ABSTRACT

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.