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Jacqueline Coblentz, Carlos Augusto Moreira, Mariana Souza, Hadeel Helmi, Sarah Alghamdi, Miguel N Burnier; Primary malignant apocrine tumors of the eyelid: frequency and histopathological characteristics. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2415.
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© 2017 Association for Research in Vision and Ophthalmology.
Primary carcinomas with apocrine differentiation (CAD) are infrequent tumors with several subtypes, including apocrine adenocarcinomas (AAs), extramammary Paget’s disease, adenoid cystic carcinoma, and mucinous carcinoma (MC). The purpose of this study is to describe the clinical and pathological characteristics of CAD in a large series of eyelid lesions.
We reviewed 5,453 ocular pathology cases diagnosed at the Henry C. Witelson Ocular Pathology Laboratory, Montreal, Quebec over a 10-year period (2006-2015). Clinical and pathological data of all CAD diagnosed during this period were retrieved. Descriptive analysis, including frequency, size, location, gender, and age, was performed.
Of the 5,453 specimens reviewed, 3,014 (55.3%) cases were eyelid lesions. Five CADs were identified. Two were AAs and three MCs (0.07% and 0.17% of all eyelid lesions, respectively). The AAs were diagnosed in a 59-year-old male and an 81-year-old female in the lower and upper eyelids, respectively. Both were clinically diagnosed as chalazion. Average lesion size was 4 mm. Histopathologically, both cases showed luminal border decapitation and eosinophilic cytoplasm of malignant epithelial cells. One AA was well demarcated with high pleomorphism, while the other showed infiltrative borders but low grade cytological features. After 2 and 3 years of follow-up, respectively, no recurrences were seen. The MCs were diagnosed in three males (61, 84, and 88 years) with an average size of 10 mm. Two of them occurred in the lower eyelid. All MCs were clinically diagnosed as cystic basal cell carcinoma. All of them were characterized by mucin pools separated by thin fibrous septa with nests of malignant cells displaying a cribriform pattern. One patient experienced local recurrence after 6 years of follow-up.
To the best of our knowledge, this is the first comprehensive review of CAD in the eyelid. In this series, the morphological spectrum of CAD includes apocrine adenocarcinoma and mucinous carcinoma. None of these cases had the correct clinical diagnosis, which reveals the difficulty in diagnosing and the masquerading nature of these lesions. Identifying the intraepithelial portion of MCs may aid in the differential diagnosis of metastatic tumors.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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