title: Histiocytoid variant of eccrine sweat gland carcinoma of the eyelid and orbit: report of five cases.
abstract: OBJECTIVE
  To study the clinicopathologic features of the histiocytoid variant of adenocarcinoma of the eccrine sweat gland of the eye and orbit.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Five patients undergoing orbital and eyelid biopsy as a diagnostic procedure.
  
  
  METHODS
  The authors examined the clinical histories and pathologic findings of five patients with eccrine adenocarcinoma of the eyelid with orbital invasion.
  
  
  METHODS
  Clinical and histopathologic examinations, including routine histopathology, immunohistochemistry, and electron microscopy studies.
  
  
  RESULTS
  The tumors presented as insidious, diffusely infiltrative, firm cutaneous masses in the periocular area that later infiltrated the orbit. Histopathologic examination revealed that the tumors infiltrated the dermis and were composed of cells with a histiocytic to signet ring appearance. Tumor cells exhibited intracellular mucin production. Immunohistochemical stains were positive in tumor cells for low and high molecular weight cytokeratins, carcinoembryonic antigen, and epithelial membrane antigen. Electron microscopic examination showed lumen formation and intracytoplasmic mucin in tumor cells.
  
  
  CONCLUSIONS
  The histiocytoid variant of adenocarcinoma of the eccrine sweat gland of the eyelid may present as an insidious tumor and diffusely invade the orbit. These cases may be confused with metastatic adenocarcinoma.
authors.affiliation: Department of Ophthalmology, Eye Center, Emory University School of Medicine, 1365-B Clifton Road, Atlanta, GA 30322, USA.
authors.forename: Theresa R
authors.initials: TR
authors.lastname: Kramer
authors.forename: Hans E
authors.initials: HE
authors.lastname: Grossniklaus
authors.forename: Ian W
authors.initials: IW
authors.lastname: McLean
authors.forename: James
authors.initials: J
authors.lastname: Orcutt
authors.forename: W Richard
authors.initials: WR
authors.lastname: Green
authors.forename: Nicholas T
authors.initials: NT
authors.lastname: Iliff
authors.forename: Francesc
authors.initials: F
authors.lastname: Tressera
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000473:pathology*; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D004439:Eccrine Glands; D005142:Eyelid Neoplasms / Q000737:chemistry / Q000473:pathology*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000378:metabolism; D009077:Mucins / Q000032:analysis; D009361:Neoplasm Invasiveness; D009918:Orbital Neoplasms / Q000737:chemistry / Q000473:pathology*; D012189:Retrospective Studies; D013544:Sweat Gland Neoplasms / Q000737:chemistry / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D018396:Mucin-1; D009077:Mucins