Mr. Zhou, 40, had a nodule on his upper eyelid a while ago. He was examined at a local hospital, and the doctor said it was a chalazion and gave him surgery to remove it, but it recurred soon after, and then again. He came to the ophthalmology clinic for this reason. After taking a medical history and examination, he was excised again and the specimen was sent for pathological examination, and it was confirmed that Mr. Zhou was suffering from chalazion adenocarcinoma. The initial symptoms are similar to those of chalazion and can easily be misdiagnosed as chalazion. Chalazion is a chronic inflammatory granuloma of the lid gland, also known as a chalazion cyst, that results from obstruction of the lid drainage ducts and retention of secretions, and is a common condition that can affect both children and adults. Both diseases are similar in that they are nodular elevations under the eyelid skin that do not adhere to the skin and do not cause significant pressure pain. When palpated, chalazion has a smooth surface with clear margins, and the conjunctiva is usually greenish-gray or slightly congested, whereas lid adenocarcinoma can be seen as a yellow nodule with an uneven surface on the skin or conjunctival surface. When the chalazion is cut open, gelatinous contents or polyp-like granulation tissue is visible inside, whereas chalazion adenocarcinoma is a cauliflower-like swelling with a rough surface. A chalazion usually does not recur if excision is complete. If there are multiple recurrences in the same location that are getting worse, they should be promptly removed and pathologically tested. If recurrent chalazia occurs in the elderly, one must be alert to the possibility of chalazion adenocarcinoma. This is because chalazia occurs easily in youth when the gland is highly productive. In old age, the glands tend to atrophy and secretion decreases, so chalazia in the elderly is relatively rare. If it occurs, it is best to have the excised lesion sectioned and examined to clarify the nature of the lesion to avoid misdiagnosis. Chalazion can be effectively controlled and treated if it is detected promptly and excised thoroughly when the lesion is small. In addition to adenocarcinoma of the eyelid, there are also basal cell carcinoma and squamous cell carcinoma on the eyelid. These two common skin cancers also occur in the elderly and can destroy the eyelid, eyeball, orbit, sinus and face in severe cases.