Periocular cutaneous oncocytoma with signs of disrupted oxygen metabolism

Abstract

Oncocytomas are benign tumors most often occurring in salivary or lacrimal glands and thyroid tissue. As cutaneous oncocytoma is exceptionally rare, this tumor is uncommonly encountered by dermatopathologists. Herein, we illustrate the case of an 80-year-old man who presented with a slowly growing papule of the lower eyelid. Histopathologically, the adenomatous tumor was composed of large monomorphic cells with eosinophilic granular cytoplasm. Electron microscopy revealed abundant, enlarged and abnormally shaped mitochondria. These findings were consistent with an oncocytoma of the skin. The presented case is unique in that the thorough work-up of the tumor tissue revealed not only hyperplastic mitochondria, representing the ultrastructural correlate of the observed granular cytoplasm, but additionally disclosed functional consequences with elevated levels of reactive oxygen specimen (ROS) within the tumor. Disrupted oxygen metabolism may result from cellular aging processes and may putatively represent the underlying pathogenesis of oncocytoma.

A rare case of cutaneous oncocytic hidradenoma

“…The histologic appearance is due to excessive amounts of cytoplasmic mitochondria, which can be visualized on electron microscopy. Mitochondrial hyperplasia in oncocytosis may be because of defective mitochondrial enzymes due to degenerative changes which accumulate with aging, and has also been associated with radiation exposure . Kontaxis et al showed that patients aged 70 and older have up to 80% incidence of incidental solitary oncocytes in aging salivary tissue.…”

“…Paraffin sections stained positive by immunohistochemistry for mES13, a mitochondrial antibody. Additional cutaneous tumors reported to show oncocytic change include cutaneous oncocytomas, periocular oncocytoma, lacrimal caruncle oncocytoma, melanocytic nevi, an eccrine acrospiroma of the eyelid and a porocarcinoma . The oncocytic change in these neoplasms usually occurs focally, and is only rarely present throughout the entire lesion.…”

“…However, a few cutaneous neoplasms with oncocytic change have been reported in the literature, most of which have been benign tumors. These reports include cases of cutaneous oncocytoma, periocular oncocytoma, oncocytoma of the lacrimal caruncle, melanocytic nevi, eccrine acrospiroma and a porocarcinoma . Herein, we report the case of a 70‐year‐old male patient with an oncocytic hidradenoma which occurred on the left scalp, and clinically was thought to be a basal cell carcinoma (BCC).…”

Periocular cutaneous oncocytoma

“…Cutaneous oncocytoma is a rare benign tumour comprised of oncocytes. Histologically, oncocytes are characterized by eosinophilic, granular cytoplasm with enlarged mitochondria . Classically, oncocytes stain positive for pancytokeratin, suggesting that they originate from epithelial cells .…”

Oncocytoma of the lacrimal caruncle and its relevancy to dermatopathology

“…The reported number of cutaneous cases only amounts to five while those of the ocular adnexa exceed over 200. 4,5 Ironically, of the five reported cutaneous cases, all but one case occurred on the periocular skin; the outlier occurred on the cheek. 4 Most reported cases of eyelid and oculocutaneous oncocytomas are ocular adnexa in origin, 2 believed to be emanating predominantly from the epithelium of the lacrimal canniculus.…”