A 45-year man presented to the ophthalmologists with a 1 year history of an expanding mass on the right lower lid.
A full thickness lower lid excision was performed.
Histology showed an expansile lesion, composed of a glandular elements. Nuclear pleomorphism and mitotic activity were identified. The cells were eosinophilic and showed bubbly to granular cytoplasm.
Fig1-low power of full thickness lid excision. Fat black arrow=tarsal conjunctiva. Thinner black arrow is skin.
Fig 2-Higher power of lesion.
Fig 3-the lesion was strongly positive for GCDFP-15 (as shown), CK-7 and EMA.
What is the diagnosis?
This is a primary apocrine adenocarcinoma of the eyelid. It has probably arisen from the Moll glands that are a type of apocrine gland. The strong GCDFP-15 staining corroborates the histological findings nicely.
In a woman, it is important to exclude metastatic breast carcinoma with apocrine differentiation, before entertaining a diagnosis of primary eyelid apocrine carcinoma.
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