Solitary eyelid neurofibroma presenting as tarsal cyst: Report of a case and review of literature

Abstract

PurposeTo report a rare case of solitary eyelid neurofiboma presenting as tarsal cyst.ObservationA 64 year old male, presented with a painless, non progressive swelling in the right upper eye lid. Examination revealed a non tender, firm, mass adherent to the underlying tarsus. Excision via a conjunctival approach was performed and the histopathology was suggestive of neurofibroma. Immunohistochemistry was positive for Vimentin and focally positive for S-100. The patient did not have any features of neurofibromatosis.Conclusionand Importance: Solitary neurofibroma of the eyelid does not have any systemic association with neurofibromatosis, and only seven such cases have been reported in English literature. We report a case of solitary neurofibroma of the eyelid presenting as tarsal cyst. A thorough review of literature of previously reported cases is included.

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“…Age at presentation is interesting. On looking at the Indian series, the range included 19 years [5], 64 years [6] and 53 years [8]. Clearly, our local patient came in early in good time.…”

“…Our patient has fared better. It may be added that the eyelid neurofibroma may present as a tarsal cyst [6], mimick chalazion [8,11], or simulate optic nerve glioma [9]. In contrast, the local surgeons were able to readily diagnose "Orbital plexiform neurofibromatosis (Type 1)."…”

“…Elsewhere [2], the appearances in infancy and childhood among the Ibo ethnic group were presented personally [3]. Here, this paper compares its odd appearance in the eyelid with reference to comparative examples from India [4][5][6][7][8], Korea [9,10], Taiwan [11] and USA [12].…”

Neurofibromatosis type 1 with tarsal conjunctiva thickening

“…Thus, it is often mistaken for chalazion. [6,7] This is the 1st report of an eyelid neurofibroma appearing as an ill-defined diffuse tarsal conjunctiva thickening that shows clinical manifestation different from chalazion.…”

“…Eyelid tumors are basically diagnosed by histopathologic examination and immunohistochemistry to distinguish them from other malignant eyelid tumors. [6–8] Neurofibroma is characterized by ill-defined cells with eosinophilic cytoplasm and wavy or comma-shaped nuclei within collagen fibers in hematoxylin and eosin staining. In addition, S-100 protein is generally positive in immunohistochemistry staining.…”