Year : 1956 | Volume
: 4 | Issue : 4 | Page : 78--80
Fibroma of lower lid-case report
Y Dayal, KC Agarwal
M. U. Institute of Ophthalmology, Gandhi Eye Hospital, Aligarh, India
M. U. Institute of Ophthalmology, Gandhi Eye Hospital, Aligarh
|How to cite this article:|
Dayal Y, Agarwal K C. Fibroma of lower lid-case report.Indian J Ophthalmol 1956;4:78-80
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Dayal Y, Agarwal K C. Fibroma of lower lid-case report. Indian J Ophthalmol [serial online] 1956 [cited 2020 Jul 5 ];4:78-80
Available from: http://www.ijo.in/text.asp?1956/4/4/78/40751
Tumours of lower lid form a hetrogenous group as almost all types are met with. -Mostly these neoplasms are benign and arise from the skin but malignant growths are also met with. The commonest tumours are the papillomata which form about 65% of all the lid tumours. (Duke-Elder 1952) Fibromas are very rare and are reported to be 5% only (0' Brian and Braley 1936). Histologically two . types are met with. Hard fibromata are usually small and rich in Collagen fibrous tissue while soft fibromata are polypoid, vascular and contain very little fibrous tissue. Rarely such tumours turn malignant, though sarcomatous changes have been seen.
This case has been reported in view of the rarity of this type of tumour in the lids.
R, a man aged 45 years was admitted to the Gandhi Eye Hospital, Aligarh on 3-1-57 with a spherical swelling on the lower lid increasing in size for the last 3 years [Figure 1]. There was no history of trauma or pain.
Local Examination :-A globular swelling about 5 cm in diameter was present in between the angle of the right lower lid and alae of the nose. It was firm in consistency and not fixed to skin or bone. The skin over the tumour mass was stretched and showed prominant vessels. The transillumination test was negative. There was no enlargement of regional lymph nodes. Vision Right Eye 6/60, Left Eye 6/36
There were lenticular opacities ?
Tension was normal.
Laboratory Investigation :
1. Blood. Total W.B.C. Count, 14,7oo/cmm. Polymorphs-8%
W. R. Test - Negative
Khan Test - Negative
2. Urine - Negative
3. Skiagram of orbit - Normal
Treatment and Operation In view of the high leucocyte count the patient was put on penicillin but he got severe urticaria which was controlled -by anti histaminics. The growth was later removed under local anaesthesia. The deeper tissues including the tarsus and bone were quite free.
Histological Examination : The tumour was globular in outline measuring 5 cm. in, diameter and weighing 52 gms. It was capsulated and was firm in consistency. The outer surface was smooth and the cut surface presented a trabeculated appearance.
The tumour was partly covered by a -thin collagenous capsule. It consisted of interlacing bundles of oval or elongated cells with spindle shaped nuclei and fair amount of cytoplasm, separated by thin fibrous strands. [Figure 3],[Figure 4]. A number of blood vessels were interspersed in the tumour mass. There was no evidence of a malignant neoplastic change-Diagnosis :-Fibroma (Soft).
While considering the differential diagnosis of such a case one has to bear in mind the different benign tumours like, adenoma of the sebacious or Meibomian glands, fibroma, lipoma, myoma, myxoma, and neurofibroma. Clinically it is not possible to differentiate the various types, as they present a similar picture. However, one may say that lipoma and myoma are usually soft with pseudo fluctuant consistency, and the common site is the upper lid. Adenomas of the Melbomian gland usually do not attain enormous size. Neurofibromata may show pigmentation of the overlying skin, and on palpating the growth a feeling of knotted cords with tenderness may be elicited. Usually these are multiple.
The origin of fibromata is very much disputed. Its site, may be dermal or subcutaneous attached to deeper tissues i.e. may arise from the muscle or nerve sheaths or it may be associated with the tarsus. The cutaneous tumours are in reality neurofibormata (molluscum fibrosum). These resemble a soft fibroma in its histological picture, but careful examination demonstrates the presence of nerve fibrillae. In such cases the growth may probably be derived from the perineurium without the participation of the nerve elements. In the present case the skin and tarsus were quite free, so the only possibility of origin may be from the muscle sheath.
A brief review of fibroma arising from the soft tissues of the lower lid is presented with a case report.
|1||Duke Elder, Sir Stewart, Text Book of Ophthalmology, Vol. V, 5072-3, 5079-II.|
|2||O'Brian and Brailey, J. Am. med. As., C viii, 933, 1936.|