Abstract Listings 2024

Purpose

To present a case of a schwannoma in the lower eyelid of a 52-yo woman, detailing the clinical presentation, surgical approach, histopathological findings, and final diagnosis.

Methods

A 52-year-old female presented with a non-painful, mobile tumoral growth in the lower eyelid, evolving over three years. The tumor was not adhered to deep or superficial planes. Surgical resection was performed via an anterior approach. Dissection was easily done in the extracapsular plane and the lesion was excised completely. The excised tumor was nodular, whitish, and measured 80x70x40 mm with an elastic consistency.

Results

Histopathological examination revealed an encapsulated tumor composed of spindle cells without cytological atypia, arranged in short fascicles. The tumor exhibited densely cellular areas with nuclear palisading (Antoni A) alternating with less cellular areas (Antoni B). No signs of malignancy were observed. Immunohistochemical studies showed strong and diffuse positivity for S-100 protein and negativity for Actin and Desmin.

Conclusion

To our knowledge, only 12 such cases have been reported in the literature. The histopathological and immunohistochemical findings confirmed the diagnosis of schwannoma. The surgical approach via anterior resection was effective, and the patient had an uneventful postoperative recovery. Schwannoma, a rare benign neurogenic tumor composed of proliferating Schwann cells, can occur in any myelinated peripheral nerve, including the eyelid.
Clinically, the tumor appeared as a solid, slowly progressive, and painless mass, often mistaken for other conditions like chalazion or inclusion cyst due to its rarity and unusual location. Management involves complete excision with clear margins to prevent recurrence and establish a definitive diagnosis. Incomplete removal is associated with recurrence and potentially more aggressive behavior. This case underscores the importance of considering schwannoma in the differential diagnosis of eyelid tumors and the necessity of complete excision to prevent recurrence.

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