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MARCELA BARROS, Guilherme Feltrin de Barros, Jacqueline Coblentz, Evangelina Esposito, Christina Mastromonaco, Miguel N Burnier; Can chalazions simulate malignancies? A case for histopathological examination of all chalazion-like lesions. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2416.
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© ARVO (1962-2015); The Authors (2016-present)
Chalazion is a localized lipogranulomatous inflammation of the eyelid that may simulate various eyelid lesions. The purpose of this study is to evaluate the accuracy of the clinical diagnosis of chalazion and review the main demographic characteristics of patients and lesions of misdiagnosed cases.
All cases seen in the Henry C. Witelson Ocular Pathology Laboratory over a 10-year period were reviewed (2006-2015). Histopathological diagnosis of the lesions and clinically relevant data including age, gender and location of the lesion were recorded. The data are presented as means and percentages.
Of 5,466 cases reviewed, 944 cases were clinically diagnosed as chalazion. Average age at diagnosis was 45.3 years with a slight male predominance (54.4%). Misdiagnosis as a chalazion was found in 6.0% (n=56) of cases, while agreement between clinical and histopathological diagnoses was evident in 94.0% (n=888) of cases. Among the misdiagnoses, 10.7% (n=6) were malignant lesions. Basal cell carcinoma (BBC) was the most frequent malignant lesion (7.1%, n=4) followed by squamous cell carcinoma (n=1), and sebaceous cell carcinoma (n=1). Malignant lesions were more frequent in the lower lid (71.4%), and all BBC cases were found in this location. Squamous cell carcinoma and sebaceous cell carcinoma only occurred in the upper lid. Benign misdiagnosed lesions were more frequent in the upper lid (79.4%). The most frequent benign misdiagnosed lesions were epithelial inclusion cyst (1.8% n=18) and sebaceous hyperplasia (1.1% n=16).
Although a clinical diagnosis of chalazion is generally accurate, malignancies can occasionally masquerade as a chalazion. Therefore, histopathological examination of all chalazions in adult patients is advised. A delay in the correct diagnosis may result in serious complications, in particular when a malignant lesion is overlooked.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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