Carcinoma of the apocrine glands at the base of eyelashes; a case report and discussion of histological diagnostic criteria

Apocrine adenocarcinoma of the eyelid with aggressive biological behavior: Report of a case

“…From these case reports and also from our experience, it should be emphasized that some cases of apocrine adenocarcinoma arising in the eyelid have the potential for rapid local growth, recurrence and regional lymph nodal and distant metastasis 3–5 . Although the number of reported cases of apocrine adenocarcinoma arising in the Moll’s gland is too few to evaluate an exact prognosis, a correlation between the degree of differentiation of the tumor cells and the prognosis has been pointed out in apocrine adenocarcinoma of the skin and breast 10,13 .…”

“…(case 4), the tumor showed extensive involvement with the paranasal sinus and lymph node metastasis, but the patient was lost to follow up. Finally, in the case documented by Thomson and Tanner, 5 the tumor showed an extensive invasion into the periorbital adipose tissue. To our knowledge, there have been no reported cases of apocrine adenocarcinoma of the Moll’s gland that have shown distant hematogenous metastasis at the time of the initial presentation.…”

“…The ceruminous gland in the external auditory canal and the Moll’s gland in the eyelid are also considered to be modified apocrine glands 10,11 . Neoplasms showing apocrine differentiation arise rarely in the ocular region, especially in the eyelid 1–8 . These apocrine neoplasms occasionally cause diagnostic problems both clinically and pathologically.…”

“…The tumor in the present case showed clearly anaplastic histopathological features, and the feature of decapitation secretion, which is considered to be a characteristic finding for the apocrine gland, 10,13 was not apparent. Neither PAS‐positive nor iron‐positive intracytoplasmic granules were demonstrated, probably reflecting the anaplastic nature of the neoplasm 5,13 . From the histopathological findings, melanocytic neoplasms, histiocytic neoplasms and oncocytoma or oncocytic adenocarcinoma were considered in the differential diagnosis.…”

“…Among benign and malignant neoplasms that involve the eyelid or lacrimal caruncle region, adenocarcinomas exhibiting differentiation towards the apocrine sweat gland are some of the most infrequent, and the details of their clinicopathological features have been documented in only a few cases 1–8 . Although apocrine adenocarcinomas arising in the ocular region are generally considered to pursue a relatively indolent and protracted clinical course, 1,2 , 7,8 a few cases showing very aggressive biological behavior have also been reported 4,5 . The exact histogenesis of apocrine gland neoplasms in the ocular region is still unclear, but origin from the Moll’s gland, an apocrine gland located at the roots of the eyelashes, is considered most likely 1–8 …”