A Clinical Case of a Right Eyelid Multilobulated Lesion: Invasive Sebaceous Carcinoma Masquerading as Chalazion

Sebaceous carcinoma (SC) is a rare and aggressive malignancy of the sebaceous glands, most commonly arising from the eyelid. The general presentation of SC varies, resulting in delayed identification and frequent misdiagnosis. Clinicians should include SC in a differential diagnosis when a patient presents with an eyelid lesion. Undiagnosed and untreated SC can have detrimental outcomes; therefore, early diagnosis and treatment are imperative to decrease mortality and morbidity. This is the case of a 71-year-old male referred by his primary care physician to the ophthalmologist for an inflamed, multilobulated lesion on his right upper eyelid. The patient was initially diagnosed with chalazion and prescribed Vigamox. A shave biopsy was obtained and sent to pathology, which revealed the diagnosis of invasive SC. The patient was subsequently referred to oncology and general surgery for multidisciplinary management. This case report highlights a unique account of invasive SC initially misdiagnosed as chalazion, underscoring the importance of thorough evaluation and awareness of this rare presentation.