Department of Ophthalmology, Hangil Eye Hospital, #35 Bupyeong‑Daero, 21388, Bupyeong‑Gu, Incheon, Republic of Korea.
Department of Pathology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
BMC Ophthalmol. 2024 Jan 2;24(1):1. doi: 10.1186/s12886-023-03262-z.
Angiosarcoma is an extremely rare malignant tumor. So far, only about 42 cases of angiosarcoma involving the eyelids have been reported. Eyelid angiosarcoma occurs more frequently in elderly Caucasian males and is prone to misdiagnosis. We present a case report in a young Asian male patient with eyelid angiosarcoma that was misdiagnosed as a chalazion.
A 46-year-old South Korean male with no underlying disease had a right lower lid mass. The lesion was initially misdiagnosed as a chalazion at a local clinic, but a diagnosis of eyelid angiosarcoma was made after the first biopsy trial. PET-CT was performed to ensure that there was no metastasis in the whole body. Surgical excision with enough surgical margin was used alone for treatment and reconstruction was performed with a tarsoconjunctival advancement flap (modified Hughes procedure), which helped ensure good cosmesis. No recurrence was observed 4 years and 5 months after the surgery.
The current study presents the first case of chalazion-mimicked eyelid angiosarcoma in a young Asian male aged under 50 years. This case shows that even if a benign eyelid disease is suspected in a young patient, an incisional biopsy must be performed to confirm whether the lesion is malignant. Since the prognosis is good for the case of eyelid angiosarcoma, if there is no clear evidence of distal metastasis, surgical resection should be performed with an enough safety margin.
血管肉瘤是一种极为罕见的恶性肿瘤。迄今为止，仅报道了约 42 例涉及眼睑的血管肉瘤病例。眼睑血管肉瘤在老年白种男性中更为常见，且易误诊。我们报告了一例年轻亚裔男性的眼睑血管肉瘤病例，该病例最初误诊为霰粒肿。
一名 46 岁的韩国男性，无基础疾病，右侧下眼睑有一肿块。病变最初在当地诊所被误诊为霰粒肿，但首次活检后被诊断为眼睑血管肉瘤。为了确保全身无转移，进行了 PET-CT 检查。单独采用手术切除并保证足够的手术切缘，并用睑板结膜推进皮瓣（改良 Hughes 术）进行重建，有助于确保良好的美容效果。手术后 4 年零 5 个月未观察到复发。
本研究首次报道了一例 50 岁以下年轻亚裔男性表现为霰粒肿样的眼睑血管肉瘤。该病例表明，即使怀疑年轻患者患有良性眼睑疾病，也必须进行切取活检以确认病变是否为恶性。由于眼睑血管肉瘤的预后良好，如果没有明确的远处转移证据，应进行具有足够安全切缘的手术切除。
