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Photo Essay
September 1998

Subepidermal Calcified Nodule

Arch Ophthalmol. 1998;116(9):1254-1255. doi:10.1001/archopht.116.9.1254

A 7-year-old girl was seen for evaluation of a small tumor on her left upper eyelid (Figure 1). She first noted the lesion 7 months earlier. Suspecting a retention cyst at that time, 2 punctures of the tumor were performed by an ophthalmologist. Examination findings disclosed a firm, well-circumscribed, slightly elevated yellow-white tumor. Findings from her general medical history and ophthalmic and physical examinations that included standard laboratory tests were unremarkable. An excisional biopsy of the tumor was performed. Results of histopathologic examination disclosed focal subepithelial calcification beneath a multilayered cornifying squamous epithelium with acanthosis and hyperkeratosis (Figure 2). Findings from von Kossa staining for calcium were positive in this area (Figure 3). Adjacent to the calcium deposits a foreign body granulomatous inflammatory reaction with giant cells was observed (Figure 4). Results of Feulgen staining for DNA and Gram staining were negative within the calcified masses. No recurrence occurred in the last year.