Malignant appearing benign lid tumor – An isolated upper lid schwannoma

Abstract

Sebaceous carcinoma is notorious for masquerading as other benign and malignant lesions. A 50-year-old male presented with a painless mass on the lateral aspect of the right upper lid. On examination, there was a 25 mm ××× 20 mm ×× 14 mm, nontender, well-defined, nodular mass hanging from the lateral aspect of the left upper lid with loss of lid margin architecture, and lashes locally. A differential diagnosis of sebaceous cell carcinoma was made. He was taken up for excision biopsy with frozen section control of margins which to our surprise revealed a spindle cell tumor with no signs of malignancy. Later on detailed histopathological examination and immunohistology of excised mass, a diagnosis of schwannoma of eyelid was reached. It is, therefore, better to err on the side of caution, diagnosing, and managing such dubious tumors vigilantly. Schwannomas thought very rare, should be kept in mind as a differential of the upper eyelid tumors.