lid tumors occurring in children are usually congenital and sometimes cause disturbance of the visual development as well as being a cosmetic problem . eccrine hidrocystomas are usually small , thin - walled retention cysts that occur in adulthood [ 1 , 2 , 3 ] . , we report a case of a boy who presented with an upper - eyelid tumor that led to mechanical ptosis and amblyopia . a 5-month - old boy was referred to us for further examination of his right upper - eyelid tumor . the tumor was 8 mm in diameter and observed in the upper eyelid ( fig . according to his parents , the tumor was first noticed at the child 's birth . as the patient could open his eye , it was assumed that the tumor most likely would not affect the visual development in his right eye . therefore , at that time , we decided that a follow - up examination was the best option for the patient . however , due to a gradual enlargement of the tumor , the patient returned 2 years later and underwent further evaluation ( fig . at the time of the follow - up examination , the tumor exhibited a distinct boundary and was 12 mm in size . physical examination revealed that there was no pain or any inflammatory reaction in the lid . when observed from the side of the palpebral conjunctiva , the tumor was found to be buried beneath a portion of the tarsal plate and showed a translucent configuration ( fig . 1c ) . a t2-enhanced magnetic resonance imaging ( mri ) examination demonstrated that the tumor was well demarcated from the surrounding tissue . this uniformly high - intensity lesion was 12 mm ( height )  12 mm ( width )  8 mm ( depth ) in size , with the lesion observed to be in direct contact with the tarsal plate ( fig . since the tumor caused blepharoptosis in the patient 's right eye , this subsequently led to oblique astigmatism . therefore , 2 months later , it was decided to surgically remove the mass lesion . the wall of the tumor was easily separated from the surrounding connective tissues , with the exception of the portion where the tarsal plate was attached . as a result , the tumor was completely removed along with a round defect of the tarsal plate ( fig . pathological examination showed that the tumor was composed of a thin wall and contained a transparent liquid . the wall consisted of a single cuboidal epithelium that covered the inner luminal surface without decapitation . although there was obvious improvement in the blepharoptosis after the surgery , his best - corrected visual acuities remained at 0.2 od and 1.2 os due to the refractive astigmatic amblyopia that was present at 2 weeks after the procedure . thus , the patient was provided with a prescription for glasses and , with the help of his parents , began a training program designed for the visual recovery of his right eye . two years later , his best - corrected visual acuities recovered to 1.0 od ( fig . eccrine hidrocystomas usually result from the dilation of cystic excretory eccrine glands due to the retention of sweat in conjunction with the dilation or blockage of the sweat duct [ 1 , 2 , 3 , 4 , 5 ] . under a microscope , eccrine hidrocystomas appear as unilocular cysts that usually contain a single cystic cavity composed of one or two layers of cuboidal cells . these are located within the mid - dermal to superficial layers of the skin , especially around the eyes . the mean age at diagnosis was 59 years ( range 3991 ) and most of the patients ( 71% ) were found to have only one tumor . almost all of the tumors ( 97% ) were < 10 mm in size , with the vast majority ( 75% ) observed to have a maximal diameter of < 5 mm . at the present time , the study by nam et al .   is the only one to have previously reported a case of eccrine hidrocystoma arising in childhood . in our current case , the tumor was originally identified at birth as a large cyst that was located in the lid , with adherence to the tarsal plate . since the tumor , with the exception of the portion where the tarsal plate was attached , could be easily separated from the surrounding connective tissues , the lesion may have arisen from an eccrine gland of an aberrated origin . although this case did not lead to this complication , the large - sized tumor arising at birth did affect the corneal curvature , thereby resulting in high astigmatism . from the standpoint of amblyopia prevention , eyelid tumors during childhood need to be cautiously examined and treated properly .
a 2-year - old boy with an upper - eyelid tumor in his right eye underwent complete resection . 
 pathological examination showed that the tumor was composed of a thin wall , lined by a single cuboidal epithelium , and contained a transparent liquid . 
 the epithelium of the tumor wall did not display decapitation and the tumor was diagnosed as eccrine hidrocystoma . after resection , obvious improvement of the tumor - caused blepharoptosis was observed and the visual acuity of the patient recovered .