The reported recommendation for routine histopathological evaluation of the lacrimal sac wall when performing DCR surgery is not supported by this consecutive series. The authors recommend histopathological evaluation only in the setting of pre-existing clinical suspicion of malignancy, or an abnormal intra-operative appearance of the lacrimal sac.
We present a report of a recurrent atypical fibroxanthoma (AFX), a tumour known rarely to involve the eyelid. A 61 year-old male was referred after reappearance of a lower eyelid AFX within two months of resection. The neoplastic spindle cells at the periphery of an AFX may be difficult to differentiate from dermal fibroblasts in frozen sections. Paraffin sections provide better histological definition and thus greater accuracy in determining completeness of excision. The patient's recurrent tumour was surgically excised and overnight paraffin sections were used to obtain margin clearance, before secondary reconstruction. The tumour required re-excision on three occasions before clearance was achieved. The patient remains tumour free at 12 months' follow-up.
Infantile myofibroma is a rare benign tumor usually diagnosed before the age of 2 and found in the head and neck but much more rarely in the orbital region. There have only been 7 cases of periorbital myofibromas reported in children in the literature to date. The current case is of an 8-year-old boy with a left upper eyelid myofibroma confirmed on histopathological and immunochemical analysis. A literature review of periorbital myofibromas has been performed to bring the reader up-to-date with the current understanding and management of the disease.
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