Pyogenic Granuloma on Upper Eyelid

Leonid Skorin, Jr, DO

A 55-year-old woman complained of the sensation of a foreign body in her swollen left upper eyelid. A hard, painless lump was readily discerned during palpation. Eversion of the left upper eyelid revealed a fleshy, red, sessile conjunctival mass. No purulent drainage was noted.

A 55-year-old woman complained of the sensation of a foreign body in her swollen left upper eyelid. A hard, painless lump was readily discerned during palpation. Eversion of the left upper eyelid revealed a fleshy, red, sessile conjunctival mass. No purulent drainage was noted.

This is a pyogenic granuloma that formed from a chalazion of the meibomian gland, which ruptured through the tarsal conjunctiva. Pyogenic granuloma rarely occur spontaneously; typically, they arise after trauma or surgery or develop over infectious lesions.

The term pyogenic granuloma is a misnomer because neither infection nor granulomatous inflammation is present. Rather, the lesion is composed of endothelial cells of budding capillaries, lymphocytes, plasma cells, and fibroblasts.

Total excision and curettement of the lesion and its underlying chalazion resolved the condition. Pathologic evaluation of a specimen of the lesion is recommended because several other benign and malignant neoplasms, such as Kaposi sarcoma, may mimic pyogenic granuloma.