Palpebral Tarsal Solitary Neurofibroma

Abstract

Solitary neurofibroma is a rare, benign tumor of the peripheral nerve sheath, and is often associated with neurofibromatosis type 1. Herein, a case of palpebral tarsal solitary neurofibroma in a patient without neurofibromatosis is presented, with a review of the literature. A 68-year-old man presented with a subcutaneous mass in the right upper eyelid of 6 months’ duration. Eversion of the eyelid revealed a round, reddish mass on the lateral part of the tarsal plate which measured 12x8 mm in size. The lesion was excised with its tarsal base, diagnosed histologically, and did not recur during a follow-up of 34 months. Isolated, solitary neurofibroma of the eyelid has been reported in a total of 7 cases, including the case presented herein. The tumors arose from the eyelid margin in 4 cases, from the tarsal plate in 2 cases, and from the supratarsal conjunctiva in 1 case. The tumor did not recur after surgical excision in 5 cases for which follow-up data were available.

Keywords: Eyelid; neurofibroma; tarsus; tumor.

Figure 1

A) The patient presented with a painless subcutaneous mass located on the lateral side of the right upper eyelid; B) A solitary neurofibroma originates from the tarsal plate of the upper eyelid; C) Appearance of the tumor after bisection; D) Tumor tissue consisted of spindle-shaped, well-demarcated cells in the conjunctiva, with comma- or fusiform-shaped nuclei (Hematoxylin-eosin, x100); E) Masson’s trichrome stain revealed intense collagenization in the tumor stroma (blue, x100); F) Immunohistochemical staining in tumor cells showing S100 positivity and indicating neural origin (x100)