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Cellular neurothekeoma of the eyelid: a unique internal palpebral presentation
Daniel R Lefebvre1, Leslie Robinson-Bostom, Michael E Migliori
1*Division of Ophthalmic Plastic Surgery, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; †Division of Ophthalmology and ‡Department of Dermatology, Division of Dermatopathology, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, U.S.A.
Insights
A rare cellular neurothekeoma mimicked a chalazion in a woman's eyelid. This benign tumor's unusual presentation highlights the need for careful diagnosis of eyelid masses.
Area of Science:
- Ophthalmology
- Dermatopathology
- Oncology
Background:
- Neurothekeoma is a rare, benign fibrohistiocytic neoplasm.
- The cellular variant of neurothekeoma is uncommon and its origin is not fully understood.
- Eyelid tumors can present with varied clinical appearances, sometimes mimicking more common conditions.
Observation:
- A 50-year-old woman presented with an inferolateral palpebral conjunctival mass resembling a chalazion.
- The lesion's unusual presentation prompted an excisional biopsy for diagnosis.
- Histopathology confirmed the mass as a cellular neurothekeoma.
Findings:
- The diagnosis was cellular neurothekeoma, a rare benign tumor.
- This specific case involved a completely internal eyelid location, which is particularly uncommon.
- Previous reports of cellular neurothekeoma in the eyelid typically describe external or unspecified locations.
Implications:
- This case demonstrates how a chalazion can masquerade as other eyelid conditions.
- It underscores the importance of a broad differential diagnosis for atypical eyelid lesions.
- Maintaining a high index of suspicion is crucial for accurate diagnosis and appropriate management of eyelid masses.
Abstract:
A 50-year-old woman presented with a mass lesion of the inferolateral palpebral conjunctiva similar in appearance to a chalazion, but unusual enough in presentation that excisional biopsy was initially performed. Histopathologic analysis revealed a dermal fibrohistiocytic neoplasm consistent with cellular neurothekeoma. Neurothekeoma is a benign tumor; the cellular variant is rare and of unclear histogenesis. Completely internal eyelid location is particularly rare, with other identifiable case reports of cellular neurothekeoma palpebrae referring to external or unspecified eyelid location. This case provides an example of the chalazion as masquerader and re-emphasizes the importance of maintaining a broad differential diagnosis and high index of suspicion regarding atypically appearing chalazia.
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