Paraffin histology sections and delayed repair in recurrent atypical fibroxanthoma of the eyelid.

We present a report of a recurrent atypical fibroxanthoma (AFX), a tumour known rarely to involve the eyelid. A 61 year-old male was referred after reappearance of a lower eyelid AFX within two months of resection. The neoplastic spindle cells at the periphery of an AFX may be difficult to differentiate from dermal fibroblasts in frozen sections. Paraffin sections provide better histological definition and thus greater accuracy in determining completeness of excision. The patient’s recurrent tumour was surgically excised and overnight paraffin sections were used to obtain margin clearance, before secondary reconstruction. The tumour required re-excision on three occasions before clearance was achieved. The patient remains tumour free at 12 months’ follow-up.