title: Eyelid Mycetoma Masquerading as Sebaceous Carcinoma.
abstract: A 56-year-old Asian woman presented with an upper eyelid mass. The lesion was exposed after eversion of the eyelid revealing a thickened tarsus with yellowish areas. Working diagnosis was sebaceous carcinoma. Biopsy was performed. Histopathological studies showed a mycotic eumycetoma with Splendore-Hoeppli phenomena and - microbiologic cultures grew Scedosporium apiospermum. The patient was started on voriconazole 200 mg po bid with adequate serum levels. A complete response was observed after 18 weeks of voriconazole therapy. To the best of our knowledge, this is the first published case of S. apiospermum eumycotic mycetoma of the eyelid. It is important to consider mycotic infection in the differential diagnosis of eyelid tumors even in healthy patients.
authors.affiliation: *Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Quebec, Canada; †Pathology Department, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile; ‡Ophthalmology Department, and §Departments of Medicine, Microbiology and Immunology, McGill University, Montreal, Quebec, Canada.
authors.forename: Pablo
authors.initials: P
authors.lastname: Zoroquiain
authors.forename: Sarah
authors.initials: S
authors.lastname: Alghamdi
authors.forename: Bryan
authors.initials: B
authors.lastname: Arthurs
authors.forename: Leonard
authors.initials: L
authors.lastname: Levin
authors.forename: Donald C
authors.initials: DC
authors.lastname: Sheppard
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ralph
authors.forename: Julia
authors.initials: J
authors.lastname: Burnier
authors.forename: Miguel N
authors.initials: MN
authors.lastname: Burnier
mesh_terms: D018266:Adenocarcinoma, Sebaceous / Q000175:diagnosis*; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D003937:Diagnosis, Differential; D015821:Eye Infections, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005141:Eyelid Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005142:Eyelid Neoplasms / Q000175:diagnosis*; D005143:Eyelids / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D008271:Mycetoma / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D021681:Scedosporium / Q000302:isolation & purification*; D012626:Sebaceous Gland Neoplasms / Q000175:diagnosis*; D065819:Voriconazole / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D065819:Voriconazole