A 63-year-old white man developed a small nodular inflammatory mass on the tarsal surface of the right upper eyelid, which was twice incised and curetted. After the second recurrence, biopsy revealed an adenocarcinoma of the meibomian gland, a rare tumor, the malignant potential of which is often underestimated. A large resection was required to excise the lesion and provide tissue margins free of tumor on frozen section. Serial sections were utilized to construct montage that demonstrated four unconnected sites of tumor. Most important to adequate therapy are early biopsy in cases of persistent or recurrent eyelid inflammation, wide initial surgical excision with careful frozen sections for proved cases, and long-term follow-up due to the frequency of recurrences and metastases.
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