Skin tumours: sebaceous carcinoma of the eyelid: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Skin tumours: sebaceous carcinoma of the eyelid

Sample item

A 68-year-old woman has had a firm eyelid nodule diagnosed as chalazion that recurred twice at the same site after curettage, with madarosis of the adjacent lashes. What is the next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Full-thickness eyelid biopsy to exclude sebaceous carcinoma

Sebaceous carcinoma arises from meibomian glands and mimics chalazion or chronic blepharitis. A recurrent or atypical eyelid lesion in an older person with lash loss needs biopsy. It can spread in a pagetoid pattern, and early wide excision, often with margin control, improves outcome.

Option by option

  • A. Full-thickness eyelid biopsy to exclude sebaceous carcinoma (correct)

    Correct. Recurrent chalazion with lash loss needs biopsy because it may be sebaceous carcinoma.

  • B. Observation for another 6 months

    Waiting allows an aggressive tumour to progress.

  • C. Topical corticosteroid

    Topical steroid does not treat a malignant mimic.

  • D. Repeat incision and curettage

    Repeating curettage delays the diagnosis of a possible malignancy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is A, Full-thickness eyelid biopsy to exclude sebaceous carcinoma. Sebaceous carcinoma arises from meibomian glands and mimics chalazion or chronic blepharitis.

Why is "Observation for another 6 months" not the answer?

Waiting allows an aggressive tumour to progress.

Why is "Topical corticosteroid" not the answer?

Topical steroid does not treat a malignant mimic.

Why is "Repeat incision and curettage" not the answer?

Repeating curettage delays the diagnosis of a possible malignancy.

What concept does this question test?

It tests Skin tumours: sebaceous carcinoma of the eyelid in Dermatology. A recurrent or atypical eyelid lesion in an older person with lash loss needs biopsy. It can spread in a pagetoid pattern, and early wide excision, often with margin control, improves outcome.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Skin tumours: sebaceous carcinoma of the eyelid?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.