title: Hypertrophic scar of the conjunctiva presenting as an eyelid mass: an unusual complication after surgical treatment of a chalazion.
abstract: OBJECTIVE
  To present a rare case of a conjunctival hypertrophic scar presenting as eyelid mass after surgical treatment of a chalazion.
  
  
  METHODS
  A 74-year-old man visited our clinic with severe ocular discomfort and excessive lacrimation since several months in his left eye accompanied by itching of the upper eyelid. Examination of the anterior segment revealed a 6 mm (horizontal) × 8 mm (vertical) round, immobile, hard, mushroom-shaped protruding mass on the tarsal conjunctiva of his left eye. There was no associated pigmentation, ulceration, or tenderness. Excisional biopsy of the benign conjunctival tumor was performed using radiofrequency electrosurgical systems. The region of the excised conjunctiva was well-healed on postoperative day 14, and there was no recurrence until 1 year post-surgery. Histopathological examination demonstrated thick interlacing collagenous fibrous bundles oriented in random directions and fibroblastic proliferation. Immunohistochemical staining revealed that spindle-shaped fibroblasts were positive for CD34 and negative for smooth muscle actin. The excessive collagenous tissue was stained blue by Masson trichrome stain. These findings were consistent with a hypertrophic scar of the conjunctiva.
  
  
  CONCLUSIONS
  This short report demonstrates that a hypertrophic scar of the conjunctiva can develop after surgery of a chalazion and cause severe ocular discomfort and excessive lacrimation. These lesions can be easily removed using simple excision.
authors.affiliation: Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Republic of Korea.
authors.forename: Jun Hyuk
authors.initials: JH
authors.lastname: Son
authors.affiliation: Department of Pathology, Yeungnam University College of Medicine, Daegu, Republic of Korea.
authors.forename: Joon Hyuk
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Republic of Korea ; Department of Ophthalmology, Daegu Veterans Health Service Medical Center, #60 Wolgok-ro, Dalseo-gu, Daegu, 704-802 Republic of Korea.
authors.forename: Su-Ho
authors.identifier: 0000-0003-3807-4163
authors.initials: SH
authors.lastname: Lim
keywords: Chalazion; Eyelid mass; Hypertrophic scar