Abstract
P 039
Carcinoma of the meibomian gland
Lutz Becker, Gerhard K. Lang, Stephan Eckert
Universitäts-Augenklinik Ulm
Objective
Tumors of the eyelids include numerous benign and malignant lesions. While the benign ones can be observed or surgically removed, the malignant tumors of the eyelid have to be removed completely followed by a reconstruction of the defect. Because the malignant lesions can be misdiagnosed as harmless inflammations, initial diagnosis is frequently delayed.
Methods
We examined a 74-year old male with a carcinoma of the upper eyelid.
Results
The patient applied in April 2008 with a swelling of the left upper eyelid, which has grown for a few months. He was refered to us with the diagnosis of a chalazion. Inspection showed a red prominent tumor of the upper eyelid with an erosive tarsal surface. The visual acuity was 0,9 on the right and 0,7 on the left eye. There were no further pathologies except a beginning cataract on both sides. Biopsy of the tumour was carried out showing a less differentiated, invasive sebaceous gland carcinoma. A Cutler-Beard procedure with complete excision of the carcinoma and reconstruction of the defect followed. The tumor staging excluded metastasis. Above from a probably reactive swelling after the surgery no prominent lymph nodes were found in the ENT-diagnostics. The eye was reopened in July 2008.
Conclusions
Carcinoma of the meibomian gland is rare, but one of the most frequently metastasizing tumors of the eyelid. Mostly located on the upper eyelid it grows destructive. It is often misdiagnosed as chronic blepharitis, a hordeolum or like in this case as a chalazion. Especially in old patients, if the therapy is ineffective or the tumor proceeds in growth a malignant origin should be considered. Therefore histological examination has to be performed. Complete surgical excision with following reconstruction of the defect is required.
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