|Year : 1983 | Volume
| Issue : 4 | Page : 327-328
Meibomian gland carcinoma
IM Shukla, PK Mukherjee, DK Das
Deptt. of Ophthalmology, Medical College, Raipur, India
I M Shukla
Prof. and Head Dept. of Ophthalmology Medical College, Raipur
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Shukla I M, Mukherjee P K, Das D K. Meibomian gland carcinoma. Indian J Ophthalmol 1983;31:327-8
Meibomian gland carcinoma is slowly growing, yellowish white tumour in tarsal portion of the lids, which may initially look benign in appearance and most commonly present an inflammatory picture typical of a chalazion. These are uncommon but not as rare as they were thought to be.
| Materials and methods|| |
There were 60 cases of malignant lid tumours admitted in D.K. Hospital, Raipur during 1976 to 1981. Out of these; 10 cases were diagnosed clinically as Meibomian gland carcinoma and confirmed by histopathology. 80 per cent case had received treatment for mistaken diagnosis of chalazion in the past.
In six cases the tumour was excised with margin of healthy tissue and the resultant coloboma was repaired by plastic reconstruction. In one case the tumour involved the fornix and was fixed to bone. This was subjected to palliative rediotherapy. Rest of the cases left against Medical advise following biopsy.
| Observations|| |
The present series comprises of 10 cases of Meibomian gland carcinoma seen over the last 5 years. In all 60 case as of malignant lid tumours were observed during the above period. The biopsy was taken or tumour was excised completely and presented for histo-pathological study. The incidence came out to be about 16.5 per cent of all malignant lid tumours. The patients belonged to the age group ranging from 35 to 64 years, 60 percent cases seen over 50 years. The upper lid was affected in most of the cases. Lower lid was seen involved only in one case (No.5). A nodular swelling was the most common presenting sign, however only one case presented as a chronic non-healing ulcer in palpebral conjunctiva with discharge and redness.
The duration of swelling varied from 3 months to one year and it was firm to hard in consistancy. Most of the cases had been mistakenly curetted for chalazion with a recurrence. Regional lymph nodes were seen involved only in 4 cases.
Surgical excision with plastic reconstruction was under-taken in 6 cases. In 4 cases only biopsy was undertaken. Out of these in one case where tumour was in advanced stage, palliative rediotherapy was given, where as others left against medicai advise.
There was no recurrence in any case treated surgically.
| Discussion|| |
The importance of early recognition and prompt adequate surgical excision of Meibomian gland carcinoma simulating as an extraocular inflammatory disease has been emphasized by Boniuk & Zimmerman. It is well recognised that Meibomian carcinoma in its early stage may simulate a chalazion. 90 per cent of the cases in our series initially presented as chalazion. So all casses of recurrent unilateral lid inflammatory, disease in elderly patients should thus be viewed with a high index of suspicion for a possible underlying malignancy.
Some authors believe the disease involves both sexes about equally but other believe that it is much common in males.
Mostly the upper eye lid is involved twice as often as the lower. In our series out of 10 casse lower lid was involved in only one case. Almost all the case in our series were seen after 40 years of age.
Surgical repair with plastic reconstruction was performed in 6 cases with excellent results. Radiation was given to one patient, as a paliative measure due to advanced stage of growth.