Beware the empty curette!
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.


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.


CONCLUSIONS
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.
Cunniffe
Geraldine
G
Oculoplastics/Adnexal Unit, Royal Victoria Eye and Ear Hospital, Dublin, Ireland. gcunniffe@hotmail.com
Chang
Bernard Y P
BY
Kennedy
Susan
S
Moriarty
Paul
P
D008949:Adenoma, Pleomorphic / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D017043:Chalazion / Q000175:diagnosis / Q000601:surgery; D003475:Curettage; D003937:Diagnosis, Differential; D005134:Eye Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis* / Q000601:surgery; D012008:Recurrence; D014057:Tomography, X-Ray Computed