Thinking beyond chalazion!!!

• Main Authors: Harikrishnan Marappan, P Deepika Makam, Dhatri Himanshu Karanam
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: TNOA Journal of Ophthalmic Science and Research
• Subjects: chalazion; eyelid tumor; meibomian gland carcinoma
• Online Access: http://www.tnoajosr.com/article.asp?issn=2589-4528;year=2021;volume=59;issue=3;spage=292;epage=294;aulast=Marappan

A 57-year-old male complained of painless swelling in the left eye upper lid for 5 months and increasing in size for 2 months. On examination, a round well-defined, firm swelling, nontender measuring 5 mm horizontally and 7 mm vertically above the lid margin in lateral part of the upper eyelid with small yellowish pustule at the lid margin corresponding to the site of lesion. The architecture of the lid and lid margin was maintained, no telangiectasia and there were no loss of eyelashes. A provisional diagnosis of marginal chalazion was made. Then incision and curettage were done. Biopsy showed invasive meibomian gland carcinoma with malignant sebocytes, numerous mitoses, and necrosis. Later, wide excision with reconstruction by tenzels flap done after edge clearance. Sebaceous gland carcinoma though rare is an aggressive tumor, and is a great mimicker of many benign conditions leading to diagnostic difficulty. Hence thinking beyond chalazion is necessary in old age, recurrent chalazion, unilateral blepharitis, keratoconjunctivitis should arise suspicion to decease the morbidity and mortality associated with the tumor.