title: Desmoplastic trichoepithelioma:  report of a unique periocular case.
abstract: In a 58-year-old woman with blepharospasm, a slowly enlarging left inferomedial eyelid lesion developed. It measured 3 × 5 mm and was nonulcerated, well-circumscribed, whitish, upraised, and firm. An initial incomplete excision followed by a total repeated excision revealed small squamous microcysts, often exhibiting calcifications and cords of nonclefting basaloid cells embedded in a scirrhous stroma characteristic of desmoplastic trichoepithelioma (DTE). Immunohistochemical investigations disclosed CD34-positive stromal fibroblasts and many CK20-positive Merkel cells located among the epithelial cells, features absent in mimicking sclerosing basal cell carcinoma (BCC). The tumor has not recurred during 6 months of follow up. Besides BCC, the differential diagnosis chiefly concerns syringoma and microcystic adnexal carcinoma. Surgical therapy should aim at complete excision but does not have to be as extensive or aggressive as that used for morpheic or sclerosing BCC because of its lack of diffusely infiltrating margins.
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Kirzhner
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Jakobiec
authors.forename: Gary
authors.initials: G
authors.lastname: Borodic
mesh_terms: D018952:Antigens, CD34 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D001764:Blepharospasm / Q000150:complications / Q000188:drug therapy; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage; D005142:Eyelid Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053554:Keratin-20 / Q000032:analysis; D019394:Ki-67 Antigen / Q000032:analysis; D008875:Middle Aged; D012878:Skin Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D053554:Keratin-20; D019394:Ki-67 Antigen; D019274:Botulinum Toxins, Type A