title: Dermatofibroma of the eyelid with monster cells.
abstract: Dermatofibromas are most frequently encountered in women on the lower extremities, often after minor trauma. A recurrent lesion of the right lower eyelid developed in a 64-year-old woman. It harbored "monster cells" that were large, with either multiple nuclei or a single, large, convoluted, and hyperchromatic nucleus. The presence of these cells does not signify a malignant transformation. The background cells were either histiocytoid (many were adipophilin positive), spindled cells, or dendritiform cells without mitoses. Factor XIIIa, CD68, and CD163 immunostaining was positive, and a subpopulation of CD1a+Langerhans cells was intermixed. Facial and eyelid dermatofibromas are more likely to recur and deserve wider, tumor-free surgical margins. Their microscopic differential diagnosis includes a cellular scar, peripheral nerve tumor, atypical fibrous xanthoma, and dermatofibrosarcoma protuberans.
authors.affiliation: Department of Ophthalmology; The David Cogan Ophthalmic Pathology Laboratory, Massachusetts Eye and Ear Infirmary; Harvard Medical School. Electronic address: Fred_Jakobiec@meei.harvard.edu.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Jakobiec
authors.affiliation: Department of Ophthalmology; The David Cogan Ophthalmic Pathology Laboratory, Massachusetts Eye and Ear Infirmary; Harvard Medical School.
authors.forename: Yufei
authors.initials: Y
authors.lastname: Tu
authors.affiliation: Department of Ophthalmology; The David Cogan Ophthalmic Pathology Laboratory, Massachusetts Eye and Ear Infirmary; Harvard Medical School.
authors.forename: Fouad R
authors.initials: FR
authors.lastname: Zakka
authors.affiliation: Department of Dermatology, Massachusetts General Hospital.
authors.forename: Arthur K F
authors.initials: AKF
authors.lastname: Tong
mesh_terms: D003937:Diagnosis, Differential; D005141:Eyelid Diseases / Q000175:diagnosis*; D005260:Female; D006644:Histiocytes / Q000473:pathology*; D018219:Histiocytoma, Benign Fibrous / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged
keywords: CD163; Langerhans cells; dermatofibroma; eyelids; facial; factor XIIIa; histiocytes; monster cells; recurrence