A 76-year-old woman had a slowly enlarging lesion of the right lower eyelid. After obtaining incisional biopsy results consistent with adenocarcinoma, we removed the tumor and made a final diagnosis of primary mucinous adenocarcinoma of the sweat gland. The defect was repaired using ipsilateral upper lid transpositional tarso-conjunctival and skin-muscle flaps. No evidence of recurrence or metastasis was noted 42 months postoperatively. Consideration of such tumors is clinically important, since they have full metastatic potential. We therefore suggest consideration of sweat gland primary mucinous adenocarcinoma in the differential diagnosis of red or violaceous eyelid masses.
[Show abstract][Hide abstract] ABSTRACT: Mucinous eccrine carcinoma (MEC) is a rare malignant tumor that typically arises in the periorbital area.
The authors report the 73rd case of primary MEC of the skin. This patient's clinicopathologic findings and the world literature are reviewed.
Patient ages range from 8-84 years (median, 63 years). The male-to-female ratio was approximately 2:1. The racial distribution was 67% white, 32% black, and 4% Asian. Primary MEC originates in the head and neck region in approximately 75% of patients. The most common location was the periorbital area (40% or 29 of 73 patients). The local recurrence rate after conventional surgery was: eyelid, 34%; scalp, 36%; and face, 33%.
Primary MEC is often a slow-growing tumor that may recur after traditional surgical excision. Recurrent eyelid MEC tends to be locally destructive with a regional metastatic rate of 3.5% (1 of 29). The regional metastatic rate for all sites was 11%, and the distant metastatic rate was 3%.
Cancer 10/1992; 70(8):2099-104. DOI:10.1002/1097-0142(19921015)70:8<2099::AID-CNCR2820700815>3.0.CO;2-C · 4.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background: Mucinous carcinoma of the skin is a rare tumour that may involve the peri-ocular region.
Methods/Results: A case report is presented of a 73-year-old woman with a right upper lid tumour, initially diagnosed as a basal cell carcinoma. Excisional biopsy of the residual tumour revealed mucinous carcinoma. Re-examination of the original pathology proved to be mucinous carcinoma, originating in the eyelid skin. Further treatment involved wide local resection and reconstruction. Systemic investigations were undertaken to exclude the possibility of metastatic mucinous carcinoma.
Conclusion: This case is presented to alert ophthalmologists to the occurrence of this rare tumour in the peri-ocular region, to highlight the importance of surgical excision with wide margins and the need for systemic investigation to exclude a primary malignancy in other sites, in particular the gastrointestinal system and breast.
Australian and New Zealand Journal of Ophthalmology 01/1999; 27(1):71 - 73. DOI:10.1046/j.1440-1606.1999.00136.x
[Show abstract][Hide abstract] ABSTRACT: To study the clinicopathologic features of the histiocytoid variant of adenocarcinoma of the eccrine sweat gland of the eye and orbit.
Retrospective case series.
Five patients undergoing orbital and eyelid biopsy as a diagnostic procedure.
The authors examined the clinical histories and pathologic findings of five patients with eccrine adenocarcinoma of the eyelid with orbital invasion.
Clinical and histopathologic examinations, including routine histopathology, immunohistochemistry, and electron microscopy studies.
The tumors presented as insidious, diffusely infiltrative, firm cutaneous masses in the periocular area that later infiltrated the orbit. Histopathologic examination revealed that the tumors infiltrated the dermis and were composed of cells with a histiocytic to signet ring appearance. Tumor cells exhibited intracellular mucin production. Immunohistochemical stains were positive in tumor cells for low and high molecular weight cytokeratins, carcinoembryonic antigen, and epithelial membrane antigen. Electron microscopic examination showed lumen formation and intracytoplasmic mucin in tumor cells.
The histiocytoid variant of adenocarcinoma of the eccrine sweat gland of the eyelid may present as an insidious tumor and diffusely invade the orbit. These cases may be confused with metastatic adenocarcinoma.
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