A neurofibroma can occur on the eyelid as a diffuse or plexiform lesion that is often associated with von Recklinghausen's neurofibromatosis. In the earliest stages the lesion produces a characteristic S-shaped curve to the upper lid. Larger lesions produce thickening of the eyelid with secondary blepharoptosis (Fig. 8.6). Since these diffuse tumors are often difficult or impossible to completely excise, they should be managed by periodic observation or surgical debulking if they cause a major cosmetic problem.
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