title: Clinicopathological features and surgical treatment of intratarsal keratinous cysts.
abstract: OBJECTIVE
  To explore the clinical and histopathologic features and surgical outcome of intratarsal keratinous cyst (IKC).
  
  
  METHODS
  The clinical findings, histopathologic evaluations, and immunohistochemical studies in 15 cases of IKC were investigated, retrospectively.
  
  
  RESULTS
  Fifteen patients with an average age of 44.7 years had noninflamed eyelid cysts sized 1-6 mm in diameter. The cysts appeared as solid, whitish opalescent or yellow-white, mildly elevated lesions beneath the palpebral conjunctiva. The cysts embedded in the tarsus were completely excised with a portion of the adjacent tarsus by a surgical procedure through palpebral conjunctival approach. Histopathologic evaluations revealed stratified squamous epithelium linings and keratin contents, which were not identical to the common epidermal or epidermoid cysts. The results were negative for Alcian blue and periodic acid-Schiff staining and showed positive correlation to the immunoreaction for epithelial membrane antigen. No recurrence occurred in all patients who had their lesions removed completely.
  
  
  CONCLUSIONS
  Our study revealed the clinical and pathological characteristics of IKC, including the absence of inflammatory sign, lesion partially embedded in the tarsus and protruding beneath the conjunctiva with the intracystic keratinous contents, stratified squamous epithelium linings, string-like keratin contents from the histopathology sections, and strongly immunoreactivity to antibodies against epithelial membrane antigen. A complete excision of cysts with adjacent tarsectomy by transconjunctival approach was proved to be an effective treatment for prevention of recurrence.
authors: Eye Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, China. zzduan@yeah.net
authors: Zong-Duan
authors: ZD
authors: Zhang
authors: Xiang
authors: X
authors: Li
authors: Mei
authors: M
authors: Li
authors: Jing
authors: J
authors: Zhao
authors: Kai-Jing
authors: KJ
authors: Zhou
authors: Jia
authors: J
authors: Qu
mesh_terms: D000328:Adult; D000423:Alcian Blue; D015415:Biomarkers / Q000032:analysis; D004396:Coloring Agents; D003560:Cysts / Q000737:chemistry / Q000473:pathology* / Q000601:surgery*; D003937:Diagnosis, Differential; D005141:Eyelid Diseases / Q000378:metabolism / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000032:analysis; D010503:Periodic Acid-Schiff Reaction; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013194:Staining and Labeling / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004396:Coloring Agents; C060192:MUC1 protein, human; D018396:Mucin-1; D007633:Keratins; D000423:Alcian Blue