DR. SHALIN SHAH

DR. NUTAN SHAH, Dr.Khushboo Shah

Abstract

Purpose-Recurrent chalazion in the elderly is a known red flag for malignancy, classically sebaceous gland carcinoma (SGC).

Methods-75-year-female came with recurrent swelling of right upper lid for 8 months. A 10 x 6 mm firm nodular, yellowish lesion with dilated vessels, loss of eyelashes & ulceration on lateral one-third of the right upper eyelid suggested possible SGC. No palpable lymph nodes and negative systemic metastatic workup. A wide excision was done with clear margins on the frozen section. Lid and lateral canthus reconstruction were done using a periosteal flap and Tenzel skin flap.

Results-Histopathology confirmed atypical cells with palisading suggestive of nodular basal cell carcinoma (nBCC). 3 mm margins were clear. Patient is being followed up for six months, with no recurrence and a satisfactory cosmetic outcome.

Conclusion-Atypical presentation of nBCC in upper eyelid, mimicking chalazion or SGC can be missed. Detailed histopathology of every lid mass is essential.