Malakoplakia of the eyelid

A 35-year-old white man, on immunosuppressive medications for 3 1/2 years following a renal transplant, presented with a whitish-yellow mass at the medial end of the left lower eyelid. An initial incisional biopsy was performed that was misinterpreted as granular cell myoblastoma. The mass was subsequently excised and histopathologic examination revealed malakoplakia. A more extensive recurrent lesion was excised one year later. About two years after the resection of the original lesion the patient died of complications of chronic renal failure. At autopsy there was no evidence of malakoplakia either of the eyelid-or systemically. This is the first case reported of eyelid involvement by malakoplakia, a histiocytic disorder with pathognomonic histopathologic features.