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A 56-year-old man presented to the minor procedures clinic with a referral diagnosis of asymptomatic left upper lid chalazion of a year's duration (figure 1). The patient was fit with no comorbidities and had a normal ocular examination. The lid skin was normal with no history of bleeding. The cyst was immobile and appeared to be attached to the tarsal plate with the prominence being more significant on the cutaneous aspect. Due to the atypical appearance of the cyst, an excision biopsy under local anaesthetic was performed. A skin crease approach was used to gain access to the cyst. The cyst was strongly adherent to the tarsal plate with a mushroom-like configuration and needed to be uprooted. This caused a buttonhole in the upper tarsus that was left to heal. The gentleman made an uneventful recovery.
1. What are the histopathological findings present in figure 2?
2. What is the differential diagnosis for a lesion arising from the tarsal plate?
3. How would you manage this case?
FOR ANSWERS SEE 1360
Answers (FOR QUESTIONS SEE 1352)
What are the histopathological findings present in figure 2?
At scanning power figure 2A shows a cyst filled with keratinous material. The cyst …
Contributors KNA-A and SS conceived the idea for the article. KAA, SS and HSM designed the article. HSM prepared and interpreted the pathology slides. The article was drafted and revised by all three authors with final approval agreed by all.
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.