Sclerosing sweat duct carcinoma of the eyelid margin: unusual presentation of a rare tumor

Abstract

In the paper by Duffy et al1Duffy M.T. Harrison W. Sassoon J. Hornblass A. Sclerosing sweat duct carcinoma of the eyelid margin unusual presentation of a rare tumor.Ophthalmology. 1999; 106: 751-756Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar they describe 4 cases of primary sclerosing sweat duct carcinoma affecting the lower eyelid margin. The risk factors for this tumor are not yet established. We have seen a similar case2Brookes J.L. Bentley C. Verma S. et al.Microcystic adnexal carcinoma masquerading as a chalazion.. Br J Ophthalmol. 1998; 82 ([letter]): 196-197Crossref PubMed Scopus (18) Google Scholar of a 66-year-old female with microcystic adnexal carcinoma (this is a preferred name for the same tumor) on the medial lower lid. It masqueraded as a benign chalazion until a large incisional biopsy showed the histopathologic diagnosis. Our patient was immunosuppressed following retinal transplantation and this may have played a role in the development of her tumor. The benign clinical appearance of this sweat gland malignancy gives very little indication of its true identity and aggressive behavior. A large incisional biopsy is recommended to provide sufficient tissue for histopathologic evaluation. Low magnification is best to identify the solid nests, strands, and cords of dark or clear staining cells in a sclerotic stoma. Smaller biopsies can result in misdiagnosis. Once there is a histopathologic diagnosis, wide excision with horizontal frozen section control (Mohs’ micrographic surgery) with a wide free margin is recommended. Long-term follow up is essential. Author’s replyOphthalmologyVol. 107Issue 2Preview Full-Text PDF