A 56-year-old man was referred to the Department of Ophthalmology, General Hospital of Kavala, for evaluation of vision loss in his right eye. He had undergone surgical removal of a gastric tumor 15 days previously. Two days before surgery, he complained of slightly blurred vision and mild bulbar pain exacerbated by ocular movement. Immediately after surgery he reported considerable visual impairment. His past ocular history was otherwise unremarkable. Except for the recently diagnosed and treated gastric tumor, he had no other known chronic medical conditions; he did not use scheduled medications and had no known allergies. His family history was remarkable for diabetes mellitus. He worked as a civil servant and did not smoke, drink, or use drugs.
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Hidrocystomas are benign lesions with frequent localization on the eyelids and common appearance as isolated translucent cystic lesions. The multiple and bilateral localization has been associated with systemic diseases or epidermodysplasia. The histological and ultrastructural study contributes to the distinction in eccrine or apocrine. In this clinical case, multiple bilateral skin lesions of the eyelids were removed surgically from a 55-year-old male patient with free medical history. The lesions were fully removed surgically without rupture of the cysts. The obtained tissues were fixed and prepared for an anatomical pathology study as well as observation under the electron microscope. The histological study revealed cystic lesions with low cuboid epithelium and presence of cells and collagen fibrils, while the ultrastructural study also revealed the presence of apoptotic and secretory cells as well as vacuolization of the cytoplasm. No relapse of the lesions was obtained. In conclusion, the histological and ultrastructural study of multiple hidrocystomas can highlight special features that help to better classify and diagnose eccrine or apocrine hidrocystomas, while surgical removal without rupture of the cyst can prevent reappearance.
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