J Korean Ophthalmol Soc.  2017 Jan;58(1):83-86. 10.3341/jkos.2017.58.1.83.

A Case of Upper Eyelid Schwannoma

• Yang H
• Roh JH

• KMID: 2367847
• DOI: http://doi.org/10.3341/jkos.2017.58.1.83

Abstract

PURPOSE
To report a rare case of upper eyelid schwannoma presenting as a chalazion.
CASE SUMMARY
A 54-year-old male presented to our clinic with a slowly growing, painless recurred mass located in the middle area of the right upper eyelid margin. Surgical incision had been performed on a similar mass two year previous, although no histological analysis had been performed. On examination, a 4 × 3-mm-sized, firm, nonpigmented mass was palpable in the right upper eyelid, and no signs of neurofibromatosis were present elsewhere. The lesion was initially thought to be an eyelid mass, so we performed an excisional biopsy under local anesthesia. The lesion was easily isolated from the surrounding tissue and was excised completely. Histopathologically, the excised mass showed a compact arrangement of spindle cells forming palisades with Verocay bodies (Antoni A patterns). Immunohistochemistry revealed diffuse and strong S-100 protein positivity. These findings resulted in the diagnosis of eyelid schwannoma.
CONCLUSIONS
Because of its rarity and solitary feature, eyelid schwannoma can be confused with chalazion. Thus, ophthalmologists should consider schwannoma in the differential diagnosis of a slowly growing, painless recurred mass or a lesion with malignant transformation after incomplete excision.

Keyword

Eyelid; Schwannoma

MeSH Terms

Anesthesia, Local
Biopsy
Chalazion
Diagnosis
Diagnosis, Differential
Eyelids*
Humans
Immunohistochemistry
Male
Middle Aged
Neurilemmoma*
Neurofibromatoses
S100 Proteins
S100 Proteins

Figure

• 

  Figure 1. Clinical photograph of the right eye. Preoperative photograph shows a 4 × 3 mm-sized non-pigmented chala-zion-like mass on the right upper eyelid margin.

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  Figure 2. Light micrograph of excisional biopsy specimen. (A) The Antoni type A area shows cellular proliferation of spindle cells arranged in a palisading fashion (red arrows). In this case, type B area is not identified (hematoxylin-eosin, ×400). (B) Immunostaining for S100 protein is strong and dif-fuse (S-100, ×400).

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  Figure 3. Clinical photograph of the right eye at 8 weeks after excision. Postoperative photograph showed removed site was clear. No recurrence was observed.

Reference

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