Eyelid

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A photograph showing the superior eyelid. (WC/Rapidreflex)
A micrograph showing a syringoma. These are typically lower eyelid tumours. H&E stain.

The eyelid is occasionally sent to pathology. Information about the eye is found in the eye article.

General

Common lesions

The most common lesion - as per a large series of 1,541 cases:[1]

Malignant tumours of the eyelid

Malignant eyelid tumour in order of frequency:[2]

Specific entities

Xanthelasma

  • Xanthelasma palpebrarum redirects here.

General

  • ~8% of eyelid tumours in one series.[1]
  • Type of xanthoma.[3]
    • It is said that a xanthoma can be anywhere. If it is on the eyelid it is a xanthelasma; a xanthelasma is a xanthoma of the eyelid.[4]
  • Associated with increased serum lipid levels.[5]
    • Incidence of elevated cholesterol is higher in younger patients.[6]

Gross

  • Exophytic lesion (on eyelid or around it) - classically yellow.

DDx:

Microscopic

Features:

  • Collection of foamy histiocytes within the dermis.

DDx:

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Eyelid, Lesion Right Upper Lid, Excision:
- Benign skin tag with rare foamy histiocytes in keeping with an early xanthelasma.
- NEGATIVE for malignancy.

Comment:
Xanthelasma may be associated with metabolic abnormalities. A lipid profile is suggested if not done recently.  

Chalazion

Syringoma

See also

References

  1. 1.0 1.1 1.2 Gundogan, FC.; Yolcu, U.; Tas, A.; Sahin, OF.; Uzun, S.; Cermik, H.; Ozaydin, S.; Ilhan, A. et al. (2015). "Eyelid tumors: clinical data from an eye center in Ankara, Turkey.". Asian Pac J Cancer Prev 16 (10): 4265-9. PMID 26028084.
  2. Margo CE, Mulla ZD (February 1998). "Malignant tumors of the eyelid: a population-based study of non-basal cell and non-squamous cell malignant neoplasms". Arch Ophthalmol 116 (2): 195–8. doi:10.1001/archopht.116.2.195. PMID 9488271.
  3. Pathania, V.; Chatterjee, M.. "Ultrapulse carbon dioxide laser ablation of xanthelasma palpebrarum: a case series.". J Cutan Aesthet Surg 8 (1): 46-9. doi:10.4103/0974-2077.155084. PMID 25949023.
  4. URL: https://www.merriam-webster.com/medical/xanthelasma. Accessed on: May 1, 2023.
  5. Rubinstein, TJ.; Mehta, MP.; Schoenfield, L.; Perry, JD.. "Orbital xanthogranuloma in an adult patient with xanthelasma palpebrarum and hypercholesterolemia.". Ophthal Plast Reconstr Surg 30 (1): e6-8. doi:10.1097/IOP.0b013e3182873d13. PMID 23503059.
  6. Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 628. ISBN 978-0443066542.