Advertisement

Peer Reviewed

What's Your Diagnosis?

A Girl With an Asymptomatic Mass on Her Eyelid

  • Authors:
    Alexander K. C. Leung, MD
    Clinical Professor of Pediatrics, University of Calgary, and Pediatric Consultant, Alberta Children’s Hospital, Calgary, Alberta, Canada

    Amy A. M. Leung, MD
    Resident, Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada

    Kin Fon Leong, MD
    Pediatric Dermatologist, Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia

    Kam-Lun Hon, MD
    Professor of Pediatrics, Chinese University of Hong Kong

    Citation:
    Leung AKC, Leung AAM, Leong KF, Hon K-L. A girl with an asymptomatic mass on her eyelid. Consultant. 2018;58(12):343-348.


     

    A 9-year-old girl presented with an asymptomatic mass on her right eyelid of approximately 1 year’s duration. The mass was very slowly growing. There was no discharge from her eyes. Her vision was normal, and there was no history of photophobia or trauma to the eyelid. Her past health was unremarkable. The family history was noncontributory.

    On physical examination, the child had a mass measuring 6 mm in diameter on her right upper eyelid (Figure 1). The mass was firm and nontender. Extraocular movements were not restricted. The rest of the physical examination findings were unremarkable. In particular, the eyelashes were normal, and there was no dermatitis in the surrounding areas.

    Fig 1

     

     

References

REFERENCES:

  1. Özdal PÇ, Codère F, Callejo S, Caissie AL, Burnier MN. Accuracy of the clinical diagnosis of chalazion. Eye. 2004;18(2):135-138.
  2. Unal M. Chalazion treatment. Orbit. 2008;27(6):397-398.
  3. Ben Simon GJ, Huang L, Nakra T, Schwarcz RM, McCann JD, Goldberg RA. Intralesional triamcinolone acetonide injection for primary and recurrent chalazia: is it really effective. Ophthalmology. 2005;112(5):913-917.
  4. Adio AO, Alikor A, Awoyesuku E. Survey of pediatric ophthalmic diagnoses in a teaching hospital in Nigeria. Niger J Med. 2011;20(1):105-108.
  5. Dhaliwal U, Bhatia A. A rationale for therapeutic decision-making in chalazia. Orbit. 2005;24(4):227-230.
  6. Lederman C, Miller M. Hordeola and chalazia. Pediatr Rev. 1999;20(8):283-284.
  7. Gilchrist H, Lee G. Management of chalazia in general practice. Aust Fam Physician. 2009;38(5):311-314.
  8. Jordan GA, Beier K. Chalazion. StatPearls. https://www.statpearls.com/as/eyes/19276/. Updated May 18, 2018. Accessed November 14, 2018.
  9. Aoki M, Kawana S. Bilateral chalazia of the lower eyelids associated with pulmonary tuberculosis. Acta Derm Venereol. 2002;82(5):386-387.
  10. Arbabi EM, Kelly RJ, Carrim ZI. Chalazion. BMJ. 2010;341:c4044.
  11. Chen L, Chen X, Xiang Q, et al. Prevalence of low serum vitamin A levels in young children with chalazia in southwest China. Am J Ophthalmol. 2014;​157(5):1103-1108.e2.
  12. Crama N, Toolens AMP, van der Meer JWM, Cruysberg JRM. Giant chalazia in the hyperimmunoglobulinemia E (hyper-IgE) syndrome. Eur J Ophthalmol. 2004;14(3):258-260.
  13. Fraunfelder FW, Yang HK. Association between bortezomib therapy and eyelid chalazia. JAMA Ophthalmol. 2016;134(1):88-90.
  14. Grob SR, Jakobiec FA, Rashid A, Yoon MK. Chalazia associated with bortezomib therapy for multiple myeloma. Ophthalmology. 2014;121(9):1845-1847.e3.
  15. Jin KW, Shin YJ, Hyon JY. Effects of chalazia on corneal astigmatism: large-sized chalazia in middle upper eyelids compress the cornea and induce the corneal astigmatism. BMC Ophthalmol. 2017;17(1):36.
  16. Laaribi N, Abdellaoui T, Abaloun Y, et al. Chalazia associated with bortezomib therapy. J Fr Ophtalmol. 2018;41(8):e381-e382.
  17. Liang L, Ding X, Tseng SCG. High prevalence of Demodex brevis infestation in chalazia. Am J Ophthalmol. 2014;157(2):342-348.e1.
  18. Malekahmadi M, Farrahi F, Tajdini A. Serum vitamin A levels in patients with chalazion. Med Hypothesis Discov Innov Ophthalmol. 2017;6(3):63-66.
  19. Nemet AY, Vinker S, Kaiserman I. Associated morbidity of chalazia. Cornea. 2011;30(12):1376-1381.
  20. Patteri P, Serru A, Chessa ML, Loi M, Pinna A. Recurrent giant chalazia in hyperimmunoglobulin E (Job’s) syndrome. Int Ophthalmol. 2009;29(5):415-417.
  21. Schear MJ, Milman T, Steiner T, Shih C, Udell IJ, Steiner A. The association of Demodex with chalazia: A histopathologic study of the eyelid. Ophthalmic Plast Reconstr Surg. 2016;32(4):275-278.
  22. Yam JCS, Tang BSF, Chan T-M, Cheng ACK. Ocular demodicidosis as a risk factor of adult recurrent chalazion. Eur J Ophthalmol. 2014;24(2):159-163.
  23. Yin Y, Gong L. The evaluation of meibomian gland function, morphology and related medical history in Asian adult blepharokeratoconjunctivitis patients. Acta Ophthalmol. 2017;95(6):634-638.
  24. Leung AKC. Chalazion. In: Leung AKC, ed. Common Problems in Ambulatory Pediatrics: Specific Clinical Problems. Vol 2. New York, NY: Nova Science Publishers; 2011:107-110.
  25. Leung AKC. Lumps and bumps in children: cysts. Consultant Pediatricians. 2012;11(5):134-136.
  26. Duarte AF, Moreira E, Nogueira A, Santos P, Azevedo F. Chalazion surgery: advantages of a subconjunctival approach. J Cosmet Laser Ther. 2009;​11(3):154-156.
  27. Dubey R, Wang LW, Figueira EC, et al. Management of marginal chalazia: a surgical approach. Br J Ophthalmol. 2011;95(4):590,596-597.
  28. Chang M, Park J, Kyung SE. Extratarsal presentation of chalazion. Int Ophthalmol. 2017;37(6):1365-1367.
  29. Korekawa A, Nakajima K, Makita E, Nakano H, Sawamura D. External chalazion as reddish and intractable lower eyelid nodules in a child. J Dermatol. 2017;44(5):e93-e94.
  30. McAlinden C, González-Andrades M, Skiadaresi E. Hordeolum: acute abscess within an eyelid sebaceous gland. Cleve Clin J Med. 2016;83(5):332-334.
  31. Borok J, Holmes R, Dohil M. Idiopathic facial aseptic granuloma—a diagnostic challenge in pediatric dermatology. Pediatr Dermatol. 2018;35(4):​490-493.
  32. Ozer PA, Gurkan A, Kurtul BE, Kabatas EU, Beken S. Comparative clinical outcomes of pediatric patients presenting with eyelid nodules of idiopathic facial aseptic granuloma, hordeola, and chalazia. J Pediatr Ophthalmol Strabismus. 2016;53(4):206-211.
  33. Zitelli KB, Sheil AT, Fleck R, Schwentker A, Lucky AW. Idiopathic facial aseptic granuloma: review of an evolving clinical entity. Pediatr Dermatol. 2015;32(4):e136-e139.
  34. Kang S-G, Kim C-H, Cho H-K, Park M-Y, Lee Y-J, Cho M-K. Two cases of giant epidermal cyst occurring in the neck. Ann Dermatol. 2011;23(suppl 1):S135-S138.
  35. Leung AKC, Barankin B. A ruptured erythematous mass on a teen’s cheek. Consultant Pediatricians. 2013;12(12):541-543.
  36. Nigam JS, Bharti JN, Nair V, et al. Epidermal cysts: a clinicopathological analysis with emphasis on unusual findings. Int J Trichology. 2017;9(3):108-112.
  37. Leung AKC, Barankin B. Dermatofibroma. Consultant. 2016;56(6):560-561.
  38. Sampaio FMS, Gualberto GV, Cerqueira FGMd, Cerqueira AMMd, Treu CM, Vargas TJdS. Case for diagnosis. An Bras Dermatol. 2014;89(3):519-520.
  39. Alonso-Castro L, Boixeda P, Segura-Palacios JM, de Daniel-Rodríguez C, Jiménez-Gómez N, Ballester-Martínez A. Dermatofibromas treated with pulsed dye laser: clinical and dermoscopic outcomes. J Cosmet Laser Ther. 2012;14(2):98-101.
  40. Leung AKC, Barankin B, Leung AAM. What are this woman’s widespread asymptomatic nodules? Consultant. 2017;57(11):651-654.
  41. Chen N, Hsu Y-H, Lee Y-C. Solitary neurofibroma of eyelid masquerading as chalazion. Int Med Case Rep J. 2017;10:177-179.
  42. Pai HV, Abbagani S, Jaishankar PP. Isolated neurofibroma of the eyelid mimicking recurrent chalazion. Indian J Ophthalmol. 2018;66(3):451-453.
  43. Shibata N, Kitagawa K, Noda M, Sasaki H. Solitary neurofibroma without neurofibromatosis in the superior tarsal plate simulating a chalazion. Graefes Arch Clin Exp Ophthalmol. 2012;250(2):309-310.
  44. Lee S-Y, Ryu Y-J, Her Y, Sung K-Y. Pilomatricoma: an unusual presentation. Ann Dermatol. 2014;26(6):791-792.
  45. Leung AKC, Fong JHS. Pilomatricoma. Consultant Pediatricians. 2004;3(3):​142.
  46. Hada M, Meel R, Kashyap S, Jose C. Eyelid pilomatrixoma masquerading as chalazion. Can J Ophthalmol. 2017;52(2):e62-e64.
  47. Levy J, Ilsar M, Deckel Y, Maly A, Anteby I, Pe’er J. Eyelid pilomatrixoma: a description of 16 cases and a review of the literature. Surv Ophthalmol. 2008;53(5):526-535.
  48. Leung AKC, Barankin B. An adolescent with a smooth, blue-black nodule on the dorsal wrist. Consultant Pediatricians. 2014;13(11):501-503.
  49. Murata T, Kaku Y, Morita K. Common blue nevus on the upper lip: a case report. J Dermatol. 2012;39(4):419-420.
  50. Agrawal V, Acharya H, Agarwal P, Sekhon V, Sharma D. Subcutaneoscopic excision of external angular dermoid cyst in children without conspicuous scarring. Asian J Endosc Surg. 2013(3):241-244.
  51. Leung AKC, Barankin B. Lipoma. Consultant. 2017;57(5):317-318.
  52. Kansal NK, Agarwal S. Neonatal milia. Indian Pediatr. 2015;52(8):723-724.
  53. Leung AKC, Barankin B. Benign primary milia. Consultant Pediatricians. 2014;13(4):191-192.
  54. Marzuillo P, Aliberti F, Tipo V. Pneumo-orbita mimicking hordeolum. Arch Dis Child. 2016;101(2):183.
  55. Leung AKC, Barankin B. Pyogenic granuloma. Consultant. 2017;57(4):248-250.
  56. Ting PT, Barankin B. Pyogenic granuloma. Can Fam Physician. 2006;52:35-36.
  57. Karadag AS, Parish LC. The status of the seborrheic keratosis. Clin Dermatol. 2018;36(2):275-277.
  58. Leung AKC, Leung AAC. Seborrheic keratosis. Consultant. 2012;52(8):573-575.
  59. Leung AKC, Barankin B. What are these asymptomatic papules on a man’s cheeks and forehead? Consultant. 2017;57(6):355-357.
  60. Wang Q, Liu J-M, Zhang Y-Z. Premature sebaceous hyperplasia in an adolescent boy. Pediatr Dermatol. 2011;28(2):198-200.
  61. Manaa Alkatan H, Al-Mohizea A, Alsuhaibani A. A case of localized amyloidosis of the eyelid misdiagnosed as recurrent chalazion. Saudi J Ophthalmol. 2017;31(3):180-182.
  62. Nair AG, Mukherjee B, Krishnakumar S, Biswas J, Mehta RA. Unilateral primary cutaneous amyloidosis of the eyelid masquerading as a chalazion. Can J Ophthalmol. 2014;49(5):e112-e114.
  63. Ahuja S, Rao VA, Kumar P, Rajesh N, Srinivasan R. Sebaceoma of the conjunctiva presenting as a chalazion. Indian J Dermatol. 2014;59(5):521-522.
  64. Hui JI, Buchser NM, Dubovy SR. Primary eyelid leiomyoma. Ophthalmic Plast Reconstr Surg. 2011;27(4):e102-e103.
  65. Jordan D, Stoica B, Brownstein S, Ali-Ridha A. Intratarsal keratinous cyst mimicking a large chalazion. Can J Ophthalmol. 2014;49(6):e149-e151.
  66. Meena M, Mittal R, Saha D. Trichilemmal cyst of the eyelid: masquerading as recurrent chalazion. Case Rep Ophthalmol Med. 2012;2012:261414.
  67. Wang Y, Maltry A, Mokhtarzadeh A. Pleomorphic adenoma of an accessory lacrimal gland masquerading as a chalazion. Ophthalmology. 2017;124(7):​952.
  68. Al-Mujaini A, Sabt B, Al-Hadabi I. It is not chalazion. Oman J Ophthalmol. 2013;6(1):63-69.
  69. Fuente García C, Pinilla-Pagnon I, Albandea Jiménez A, Sales-Sanz M. Sebaceous carcinoma mimicking a chalazion in a young patient. Arch Soc Esp Oftalmol. 2018;93(8):e56-e57.
  70. Gill M, Garg S, Kalra R, Sen R. Sebaceous carcinoma of the eyelid diagnosed on fine needle aspiration cytology. J Cytol. 2012;29(1):75-76.
  71. Nemoto Y, Arita R, Mizota A, Sasajima Y. Differentiation between chalazion and sebaceous carcinoma by noninvasive meibography. Clin Ophthalmol. 2014;8:1869-1875.
  72. Maheshwari R, Maheshwari S. Extramedullary pasmacytoma masquerading as chalazion. Orbit. 2009;28(2-3):191-193.
  73. Makrygiannis G, Vahdani K, Giasin O. Muir-Torre syndrome masquerading as chalazion. Ophthalmic Plast Reconstr Surg. 2015;31(5):422-423.
  74. Miguel AIM, Salgado MB, Lisboa MS, Henriques F, Paiva MC, Castela GPL. Pediatric ocular rosacea: 2 cases. Eur J Ophthalmol. 2012;22(4):664-666.
  75. Sagili S, Malhotra R. The importance of considering sebaceous gland carcinoma in presumed chalazia in South Asian patients? Br J Gen Pract. 2013;​63(607):74.
  76. Waisbourd M, Leibovitch I, Sayar D, Elhasid R. Conjunctival lymphoma in a child. Cornea. 2011;30(5):598-599.
  77. Almaliotis D, Nakos E, Siempis T, et al. A para-canalicular abscess resembling an inflamed chalazion. Case Rep Ophthalmol Med. 2013;2013:​618367.
  78. Kim SC, Lee K, Lee SU. Lacrimal gland duct stones: misdiagnosed as chalazion in 3 cases. Can J Ophthalmol. 2014;49(1):102-105.
  79. Mittal R, Tripathy D, Sharma S, Balne PK. Tuberculosis of eyelid presenting as a chalazion. Ophthalmology. 2013;120(5):1103, 1103.e3-1103.e4.
  80. Agarwal PK, Ahmed TY, Diaper CJM. Retained soft contact lens masquerading as a chalazion: a case report. Indian J Ophthalmol. 2013;61(2):80-81.
  81. Wu AY, Gervasio KA, Gergoudis KN, Wei C, Oestreicher JH, Harvey JT. Conservative therapy for chalazia: is it really effective? Acta Ophthalmol. 2018;​96(4):e503-e509.
  82. Mansour AM, Chan C-C, Crawford MA, et al. Virus-induced chalazion. Eye. 2006;20(2):242-246.
  83. Cottrell DG, Bosanquet RC, Fawcett IM. Chalazions: the frequency of spontaneous resolution. Br Med J (Clin Res Ed). 1983;287(6405):1595.
  84. Honda M, Honda K. Spontaneous resolution of chalazion after 3 to 5 years. Eye Contact Lens. 2010;36(4):230-232.
  85. Chung CF, Lai JSM, Li PSH. Subcutaneous extralesional triamcinolone acetonide injection versus conservative management in the treatment of chalazion. Hong Kong Med J. 2006;12(4):278-281.
  86. Alsuhaibani AH, Al-Faky YH. Large anterior orbital cyst as a late complication of chalazion surgical drainage. Eye (Lond). 2015;29(4):585-587.
  87. Aycinena AR, Achiron A, Paul M, Burgansky-Eliash Z. Incision and curettage versus steroid injection for the treatment of chalazia: A meta-analysis. Ophthalmic Plast Reconstr Surg. 2016;32(3):220-224.
  88. Biuk D, Matić S, Barać J, Vuković MJ, Biuk E, Matić M. Chalazion management—surgical treatment versus triamcinolon application. Coll Antropol. 2013;37(suppl 1):247-250.
  89. Epstein GA, Putterman AM. Combined excision and drainage with intralesional corticosteroid injection in the treatment of chronic chalazia. Arch Ophthalmol. 1988;106(4):514-516.
  90. Putterman AM. Re: “incision and curettage versus steroid injection for treatment of chalazia: a meta-analysis.” Ophthalmic Plast Reconstr Surg. 2017;​33(2):151.