A Meibomian Gland Concretion Presenting as a Palpable Eyelid Mass: A Rare Case Report

Meibomian gland obstruction is a condition in which lipid secretions accumulate within the meibomian gland duct because of blockage of the gland orifice, leading to inflammation and the formation of a nodular lesion. In most cases, whitish lipid material can be observed at the eyelid margin. However, the formation of a true concretion within the meibomian gland duct is uncommon. Furthermore, large or clinically apparent meibomian gland concretions presenting as a palpable eyelid mass appear to be uncommon. In this report, we describe a rare presentation in which multiple interconnected concretions formed a clinically visible and palpable eyelid-margin mass.

A 64-year-old woman presented with a painful mass in the right lower eyelid that had gradually enlarged over the previous year. Slit-lamp examination revealed dilation of the meibomian gland orifices and a whitish lesion measuring approximately 6 × 3 mm along the eyelid margin. The overlying eyelid skin was thinned, allowing the underlying mass to be partially visible. Under local anesthesia, three vertical incisions were made at the meibomian gland orifices, and multiple white concretions were removed. The concretions were found to be interconnected beneath the meibomian gland duct and were excised in fragments. Histopathological examination demonstrated degenerative material with prominent cholesterol clefts and minimal inflammatory cell infiltration, findings compatible with a concretion. Postoperatively, the eyelid contour improved and the patient's pain resolved.

This case demonstrates a rare presentation of multiple interconnected concretions forming a clinically visible and palpable eyelid-margin mass. The combination of the clinical and operative findings, macroscopic appearance, and histopathological characteristics supported a diagnosis of meibomian gland concretion, although glandular or ductal tissue was not identified in the examined fragments.