콩다래끼로 오인된 아래 눈꺼풀 테두리의 피지샘상피종 1예
A Case of Eyelid Sebaceoma Mimicking Chalazion
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목적: 우안 아래 눈꺼풀 테두리에 발생한 다래끼로 오인된 피지샘상피종을 경험하였기에 이를 보고하고자 한다. 증례요약: 52세 여자 환자가 2년 전 발생한 우안 아래 눈꺼풀 테두리 종괴를 주소로 내원하였다. 이전에 다래끼로 절개배농술을 받았으나 호전되지 않았다. 우안 아래 눈꺼풀테의 바깥쪽 부분에 융기된, 단단한 종괴가 관찰되었고 눈꺼풀을 뒤집었을 때 눈꺼풀결막밑으로 황백색의 병터가 확인되었다. 국소마취하에 절제생검하였으며 병리조직학 검사에서 피지샘상피종이 진단되었다. 추가로 시행한 면역화학검사에서 mutator L homologue 1 (MLH1), mutator S homologue 2 (MSH2), mutator S homologue 6 (MSH6) 모두 양성으로 판정되었고 본인 및 가족의 내부장기 악성종양의 과거력이 없었기 때문에 Muir-Torre syndrome의 가능성은 낮을 것으로 판단되었다. 결론: 잘 치료되지 않는 다래끼의 감별진단으로 피지샘상피종을 염두에 두어야 한다.
Abstract
Purpose: To report a rare case of sebaceoma misdiagnosed as chalazion. Case summary: A 42-year-old female presented with a visible mass in her right lower eyelid. An elevated, hard mass was located at the margin of the right lower eyelid, and she had a history of incision and curettage under the clinical impression of chalazion. On eversion of the lower eyelid, the tarsal portion of the mass was visible as a white-yellowish lesion. The mass was excised under local anesthesia. A sebaceoma was diagnosed based on histopathological examinations. Immunohistochemical studies showed positive staining results for mutator L homologue 1 (MLH1), mutator S homologue 2 (MSH2), and mutator S homologue 6 (MSH6), and she had no past medical history or family history of internal malignancy, suggesting a low possibility of Muir-Torre syndrome. Conclusions: Eyelid sebaceoma should be considered as a differential diagnosis for refractory chalazion.
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