Spontaneous regression of an eyelid tumour. - GreenMedInfo Summary

BACKGROUND: The differential diagnosis of eyelid tumours is often a challenging task. A correct anamnesis can be very important for the further treatment plan.

CASE REPORT: A 73-year-old female patient presented with a tumour of her left lower eyelid which occurred two months ago. The suspected clinical diagnosis of a basal cell carcinoma was confirmed. After one month the patient was admitted for tumour excision and eyelid reconstruction, but the tumour showed marked regression. Because of a now clinically suspected keratoacanthoma, we decided to observe the tumour and cancelled surgery. Fourteen days later there was no tumor visible on her left lower eyelid. It seemed to be a spontaneous regression of a keratoacanthoma.

CONCLUSIONS: If there is a short case history of a rapidly growing eyelid tumour one should also consider keratoacanthoma as differential diagnosis. In suspected cases initial observation and control can save the patient from extended excision and eyelid reconstruction. However, an unnecessary delay of treatment due to prolonged observation without any signs of regression should be avoided. Unclear situations require a diagnostic excision to exclude a squamous cell carcinoma or basal cell carcinoma.