Beware the empty curette!

Orbit. 2002 Jun;21(2):177-80. doi: 10.1076/orbi.21.2.177.7191.

Abstract

Background and objective: Chalazions are a common occurrence in the eyelids due to chronic inflammation in the tarsal plate. Treatment of non-resolving cases may involve incision and curettage. Chalazions that are recurrent should arouse suspicion. We present a case of a pleomorphic adenoma of the palpebral portion of the lacrimal gland, which was misdiagnosed as a chalazion.

Patient and methods: A 41-year-old Caucasian lady initially presented with a swelling in the outer part of her right upper eyelid. A diagnosis of chalazion was made and two attempts at incision and curettage failed to resolve the lesion. She was then referred to the oculoplastics/adnexal unit. A more detailed examination revealed involvement of the palpebral part of her lacrimal gland. A CT-scan confirmed this and she proceeded to have a lateral orbitotomy to remove the tumour.

Results: Histological confirmation of a pleomorphic adenoma of the palpebral portion of the lacrimal gland was obtained. The lacrimal gland had been completely excised.

Conclusion: Persistent or recurrent meibomian cyst should be treated with suspicion. A careful orbital examination including lid eversion should always be performed to outrule a more sinister pathology.

Publication types

  • Case Reports

MeSH terms

  • Adenoma, Pleomorphic / diagnosis*
  • Adenoma, Pleomorphic / surgery
  • Adult
  • Chalazion / diagnosis
  • Chalazion / surgery
  • Curettage
  • Diagnosis, Differential
  • Eye Neoplasms / diagnosis*
  • Eye Neoplasms / surgery
  • Female
  • Humans
  • Lacrimal Apparatus Diseases / diagnosis*
  • Lacrimal Apparatus Diseases / surgery
  • Recurrence
  • Tomography, X-Ray Computed