Tubular apocrine adenoma of the eyelid – A case report and literature review

Abstract

Tubular apocrine adenoma is a rare benign adnexal neoplasm most commonly identified in the scalp, composed of a dermal proliferation of apocrine tubules in a background of hyalinized stroma. Tubular apocrine adenoma can be a component of various sweat gland tumors and can also morphologically overlap with other sweat gland neoplasms. Isolated tubular apocrine adenoma arising in the glands of Moll is exceedingly rare, with only 4 previously reported cases. We present a 63-year-old male with tubular apocrine adenoma of the left upper eyelid, which recurred following initial incomplete excision. Although the lesion showed focal morphologic similarity to the apocrine variant of pleomorphic adenoma (chondroid syringoma), the diagnosis of tubular apocrine adenoma was supported by fluorescence in situ hybridization studies, which demonstrated absence of PLAG1 and HMGA2 gene rearrangements seen in pleomorphic adenoma. This case illustrates the clinical, microscopic and immunohistochemical features of tubular apocrine adenoma. The recent advances in our understanding of the molecular genetics of tubular apocrine adenoma and related tumors, and how these advances shape the evolving classification of sweat gland tumors are reviewed.

Apocrine Cystadenoma of the Eyelid, a Rare Neoplasm: Expanded Immunohistologic Profile

“…Eyelid lesions that exhibit decapitation secretion have been described in such diverse entities as apocrine tubular adenoma, 3 hidradenoma, 4 pleomorphic adenoma, 5 and adenocarcinoma. 4,6 When decapitation is absent due to chronic hydrostatic pressure within a cyst lumen, the apocrine derivation may be inferred from the presence of the bilayer and supported by the positivity of characteristic immunostains such as GDCFP-15 (Gross Cystic Disease Fluid Protein 15) and CK7.…”

“…11 Mammaglobin, a marker used to distinguish cutaneous and mammary apocrine carcinoma, usually—but not always—positive in the former and negative in the latter, 11 has not been studied in benign eyelid apocrine tumors except for a single case of tubular adenoma. 3 GATA3, once considered a specific immunohistochemical marker for mammary and urothelial carcinoma, has been demonstrated in normal skin and a wide range of benign and malignant epithelial tumors. 12 The Ki67 proliferation marker is useful in confirming the benign tumor pattern after reviewing its cellularity with hematoxylin-eosin staining.…”