Ch 31 benign lid tumors

Question 1

Name this Lesion

Answer 1

Seborrheic keratosis

Question 2

Name this lesion.

Answer 2

Acrochordon (skin tag)

Question 3

a patient presents with the following lesion that began as a small flesh-colored papule on the lower lid that developed rapidly over the course of a few weeks into a dome-shaped nodule, with a central, keratin-filled crater and elevated, rolled margins.

What is the most likely dx?

Answer 3

Keratoacanthoma

Question 4

What is the management of a cutaneous horn?

Answer 4

A cutaneous horn is not a diagnosis, but a finding that requires further study.

The first step is to perform an excisional biopsy that includes the base of the session.

Further management depends on the definitive diagnosis, as it may be caused by a variety of benign or malignant lesions, including seborrheic keratosis, verruca vulgaris, and squamous or basal cell carcinoma

Question 5

In a patient that presents with multiple facial epidermal inclusion cysts and congenital hypertrophy of the retinal pigment epithelium what systemic diagnosis must be ruled out?

What systemic associations would this patient be at risk if that condition is in fact diagnosed.

Answer 5

Gardner’s syndrome

An autosomal dominant disorder characterized by intestinal polyps, multiple facial bone osteomas, fibromas and epithelial inclusion cysts of the skin, fibromatosis (dermoid tumors) of the abdominal wall, mesentery, and breasts, and multiple lesions consistent with congenital hypertrophy of the retinal pigment epithelium (CHRPE).

Question 6

Is Actinic Keratosis a Malignant Lesion?

Answer 6

No, but it does present a small risk of malignant transformation.

Question 7

Name the following lesion?

Answer 7

Actinic Keratosis

Question 8

What is the most common location for dermoid and epidermoid cysts?

Answer 8

Frotozygomatic suture.

Question 9

What is the consequence of the rupture of a dermoid/epidermoid cyst during surgery?

Answer 9

It produces an acute and severe inflammation that must be treated during the surgical act with copious irrigation and postoperatively with steroids.

Question 10

How does a dermoid/epidermoid cyst is imaged in a CT or MRI?

Answer 10

non-enhancing and well-circumscribed

Question 11

What type of Neurofibromatosis is associated with the presence of multiple neurofibromas?

Answer 11

NF-1

Question 12

To which type of neurofibromatosis are schwannomas associated?

Answer 12

NF-2

Question 13

Describe Multiple Endocrine Neoplasia syndrome, From an ophthalmological point of view.

Answer 13

A patient with past history of pheochromocytoma or thyroid carcinoma, with prominence corneal nerves and multiple neuromas, which are small nodular lesions arising from nerve fascicles that occur on the skin of the face, nose, eyelid, and Mucosal

Question 14

Is a Nevus flammeus/ port wine stain, a synonym for hemangioma?

Answer 14

No, it is actually a telangiectasia and must not be confused with cavernous or capillary hemangioma.

Question 15

If a nevus flammeus is associated with an ocular vascular hamartoma or leptomeningeal angiomatosis what dx can be made?

Answer 15

Sturge-Weber syndrome.

Question 16

What ocular bening lesion is associated to the Von-Hippel-Lindau syndrome?

Answer 16

Retinal Hemangioblastomas.

Question 17

What is the natural history of an orbital capillary hemangioma?

Answer 17

• Not congenital, clinically evident during de 2nd-6th weeks of life (95% evident by the 6th month).
• Rapid Growth during the first 6 months.
• slower growth for 6-12 months
• 2-3 years later the lesion stabilices and starts regressing
• at age 7 75% have resolved.

Question 18

What is the Kassabach-Merritt syndrome?

Answer 18

A rare Bleading diathesis caused by platelet entrapment in a large capillary hemangioma.

Must be suspected in patients presenting with orbital capillary hemangiomas (for abdominal and thoracic studies)