A 74 year old man presented with a foreign body sensation in the right eye superimposed on a slowly growing enlarging lump in the right eyelid. He had no history of recurrent infections, bleeding, weight loss, or night sweats. His only other symptom was chronic backache secondary to osteoarthritis. Past medical history included cataract extraction from the right eye 4 years previously and excision of a basal cell carcinoma from the right pinna 5 years previously. Examination revealed a large firm lesion in the right upper eyelid with no palpable lymph nodes. The clinical diagnosis was of a chalazion. The lesion was removed surgically and histopathology (Fig 1) revealed an incompletely excised extramedullary plasmacytoma with a high proliferative index and amyloid change. Immunocytochemistry was positive for IgG kappa light chains. Further investigations including full blood count, liver function tests including lactate dehydrogenase (LDH), protein electrophoresis, skeletal survey, and bone marrow aspiration were normal with no evidence of multiple myeloma. Figure 1 Photomicrograph showing …