Schwartz T L, Carter K D, Judisch G F, Nerad J A, Folberg R
Department of Ophthalmology, University of Iowa, Iowa City 52242.
Ophthalmology. 1991 Aug;98(8):1230-3. doi: 10.1016/s0161-6420(91)32151-1.
A large congenital eyelid mass prevented an infant from elevating his eyelid successfully. A small punch biopsy was initially interpreted as "consistent with a dermatofibrosarcoma protuberans." On the basis of this diagnosis, radical surgery was advised. Dermatofibrosarcoma protuberans, however, rarely affects children and seldom appears in the head and neck area. Because of the discrepancy between clinical and pathologic diagnoses, additional biopsies were performed, which disclosed the lesion to be a juvenile xanthogranuloma. The mass regressed after intralesional injections of corticosteroids. This is the first clinicopathologic description of congenital macronodular juvenile xanthogranuloma affecting the eyelids. The variability in the histologic composition of this large lesion may lead to a mistaken diagnosis of an aggressive condition that may provoke unnecessary radical surgery.
一个巨大的先天性眼睑肿物致使一名婴儿无法成功抬起眼睑。最初，一次小的钻孔活检结果被解读为“符合隆突性皮肤纤维肉瘤”。基于这一诊断，建议进行根治性手术。然而，隆突性皮肤纤维肉瘤极少累及儿童，且很少出现在头颈部区域。由于临床诊断与病理诊断存在差异，遂进行了额外的活检，结果显示该病变为幼年性黄色肉芽肿。在瘤内注射皮质类固醇后，肿物消退。这是关于累及眼睑的先天性巨结节性幼年性黄色肉芽肿的首例临床病理描述。这个大病变组织学构成的变异性可能导致对侵袭性疾病的误诊，进而引发不必要的根治性手术。
