Primary cutaneous adenoid cystic carcinoma of the upper lid: a case report and literature review.
To report on the diagnostic challenge of an adenoid cystic carcinoma arising from the eyelid. A 77-year-old male was referred to our center with a clinical diagnosis of upper eyelid chalazion for a lesion that had appeared 2 years before. A loss of cilia was observed over the cutaneous area of induration, but there was no reddening or ulceration. Incisional biopsy was performed and the specimen was submitted in formalin for histopathological examination. On light microscopy, the lesion was composed of basaloid epithelial and myoepithelial cells that were arranged in strands or nests and associated with cystic spaces that contained a deeply eosinophilic secretory substance and an Alcian blue-positive material, characteristic of adenoid cystic carcinoma. After histological diagnosis, tumor re-excision was performed to ensure adequacy of resection margins, as well as a sentinel lymph node procedure, resulting in complete excision of the malignant tumor. No recurrence was observed during the first 18 months after surgery. Adenoid cystic carcinoma is a rare and aggressive epithelial malignancy, which tends to grow slowly and should be considered in the differential diagnosis of eyelid tumors simulating chalazion.
Department of Ophthalmology, Maggiore Hospital, Largo B. Nigrisoli 2, 40100 Bologna, Italy. Stefano.cavazza@ausl.bologna.it
Stefano
S
Cavazza
Gian Luca
GL
Laffi
Laura
L
Lodi
Guido
G
Collina
D000368:Aged; D001706:Biopsy; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology* / Q000601:surgery; D017043:Chalazion / Q000175:diagnosis; D003937:Diagnosis, Differential; D005142:Eyelid Neoplasms / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D012590:Sclera / Q000637:transplantation; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps