Epithelioid fibrous histiocytoma of eyelid in children: A case report.

A 7-year-old male patient presented to Jinan Mingshui Eye Hospital (Jinan, China) in June 2025 with a 3-month history of a progressively enlarging mass on the right upper eyelid. The lesion was asymptomatic, with no associated pain, redness or discharge. Physical examination revealed a well-defined, smooth, yellow-red, round mass measuring ~6x5x5 mm at the medial canthus of the right upper eyelid, adjacent to the upper lacrimal punctum. Under general anesthesia, the tumor was completely excised in June 2025. Histopathological examination showed squamous epithelium overlying proliferations of small spindle cells, mitotic figures and scattered Touton-like giant cells. Immunohistochemistry revealed positive staining for CD68, CD163, S-100, CD1a, CD10 and anaplastic lymphoma kinase (ALK), with a Ki-67 proliferation index of ~10%. A diagnosis of ALK-positive epithelioid fibrous histiocytoma (EFH) was established. Postoperative recovery was uneventful, with no recurrence observed during a 6-month follow-up period. This case highlights an unusual presentation of EFH in a pediatric eyelid, where a rare tumor that occurred in the eyelid of a 7-year-old child was accurately diagnosed through a set of immunohistochemical panels containing tissue cell markers (CD68 and CD163), melanoma cell markers (S-100), dendritic cell markers (CD1a), mesenchymal cell markers (CD10) and ALK.