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Clinical Problem Solving
July 2014

Enlarging Mass of the Eyelid

Author Affiliations
  • 1University of Minnesota, Minneapolis
JAMA Otolaryngol Head Neck Surg. 2014;140(7):669-670. doi:10.1001/jamaoto.2014.714

A woman in her 90s presented to her physician with a 2-month history of a mass in her right eyelid that had enlarged to the point that she could no longer open her right eye. The lesion was mildly tender and associated with right submandibular and preauricular lymphadenopathy.

Physical examination revealed an approximately 3 × 2-cm tender mass in her right upper eyelid. Examination also revealed a 2-cm, firm, and mobile mid-right parotid mass and a 1-cm, firm, and mobile mass in the parotid tail, both consistent with lymph nodes. There was also ipsilateral level II lymphadenopathy. A contrast-enhanced, computed tomographic image demonstrated an approximately 3.3 × 2.1 × 1.9-cm enhancing lesion in the right upper eyelid (Figure, A) with invasion of the orbit as well as a 3.0 × 1.6 × 2.4-cm preauricular mass and necrotic lymph nodes in level II.

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