Bilateral eyelid tuberculosis masquerading as eyelid tumor: a case report

Purpose To report a case of bilateral eyelid tuberculosis (TB) in a young adult. Method Case report conducted through retrospective chart review. Results A 21-year-old man presented with bilateral, painless upper eyelid masses that had enlarged gradually over three months. He denied a history of nightly fevers, chronic productive cough, unintentional weight loss, previous ophthalmological history, and known close contact with people with TB. Ocular examination yielded normal results; eyelid eversion showed palpebral conjunctival involvement. Histopathology of biopsied palpebral tissue showed granulomatous inflammation with Langhans-type multinucleated giant cells and Ziehl-Neelsen staining showed acid-fast bacilli, confirming the diagnosis of eyelid TB. The patient was then started on an anti-TB therapy lasting six months; no recurrence was reported after therapy completion. Conclusion Eyelid TB should be considered in atypical, bilateral, persistent or recurrent eyelid masses, particularly in TB-endemic settings. Histopathological examination is valuable for establishing diagnosis.