Sebaceous gland carcinoma masquerading a chalazion - case report

Purpose: Demonstration of the importance of surgical excision and histologi cal examination in presence of an apparently harmless tumoral alteration of the eyelids. Case presentation: We report the case of a 65 year old patient suffering fr om systemic lupus erythematosus who noted a tumoral lesion on his left lowe r eyelid. Suspecting a chalazion, his dermatologist simply performed a caut erization. Six weeks later, a recurrence of the tumor appeared at the same location, and again, cauterization was done. A few weeks later, the patient consulted our clinic with a polycyclic tumor of 5 mm in diameter, involvin g the lid margin of the temporal part of the lower left eyelid. The patient had only moderate signs of blepharitis. There were no palpable preauricula r and cervical lymph nodes. Suspecting a malignant tumor, the entire tumora l lesion was removed surgically. Histopathology: The histopathologic examination showed a highly differentia ted sebaceous gland carcinoma, most probably originating from a meibomian g land. The margins of the excision were found to be tumor-free. Discussion: Sebaceous cell carcinoma is a rare entity. Depending on its his tological differentiation it can be highly malignant, infiltrative, and can metastasize. The mortality may reach 30% if low differentiation is present . As illustrated in the present case, the lesion may masquerade a chalazion . Therefore, in case of atypical lesion of the eyelid region complete surgi cal removal followed by a histopathological examination should be performed .