Meer Elana, Tse Caitlyn, Del Rosario Raul, Karlin Justin
Department of Ophthalmology, University of California, San Francisco, CA, USA.
Division of Orbital and Ophthalmic Plastic Surgery, Doheny and Stein Eye Institutes, University of California, Los Angeles, CA, USA.
Am J Ophthalmol Case Rep. 2023 Aug 19;32:101916. doi: 10.1016/j.ajoc.2023.101916. eCollection 2023 Dec.
We report a rare case of eyelid neuroma, discovered nine years after external levator advancement, presenting with recalcitrant ocular foreign body sensation and pain, persistent corneal epithelial defect, followed by corneal scarring, and ptosis.
An 85-year-old man with a history of multiple skin cancers presented with left ptosis, epiphora and recalcitrant eye pain. Nine years prior to presentation, he underwent excision of melanoma in situ of the left forehead, followed by simultaneous forehead reconstruction and left external ptosis repair. At presentation, he had left ptosis and left superior corneal scarring. Eversion of the eyelid demonstrated the presence of a nodule at the superior border of the tarsus. The patient underwent simultaneous excisional biopsy of the lesion and posterior ptosis repair by Müller muscle conjunctival resection (MMCR). He experienced postoperative resolution of pain, ptosis and epiphora. Histopathologic examination demonstrated the presence of a foreign body granuloma alongside a neuroma.
This case highlights the importance of thorough eyelid exam in individuals with ocular surface disease. We review herein the pathophysiology and histopathology of eyelid neuroma.
我们报告一例罕见的眼睑神经瘤病例，该病例在外直肌提肌推进术后九年被发现，表现为顽固性眼部异物感和疼痛、持续性角膜上皮缺损，随后出现角膜瘢痕形成以及上睑下垂。
一名有多种皮肤癌病史的85岁男性出现左眼睑下垂、溢泪和顽固性眼痛。在就诊前九年，他接受了左前额原位黑色素瘤切除术，随后同时进行了前额重建和左外睑下垂修复。就诊时，他有左眼睑下垂和左上角膜瘢痕形成。眼睑外翻显示睑板上缘有一个结节。患者接受了病变的切除活检和通过米勒肌结膜切除术（MMCR）进行的后睑下垂修复。他术后疼痛、睑下垂和溢泪症状得到缓解。组织病理学检查显示异物肉芽肿与神经瘤并存。
本病例强调了对眼表疾病患者进行全面眼睑检查的重要性。我们在此回顾眼睑神经瘤的病理生理学和组织病理学。
