Glands Of Moll Research Articles

Peri-ocular proliferative apocrine hidrocystoma (cystadenoma): A clinicopathological case series

IntroductionApocrine cystadenomas are rare, benign tumors that might arise in the periocular region from glands of Moll. They characteristically demonstrate proliferative features on histopathological examination, which differentiate them from simple hidrocystomas. Presentation of casesWe retrospectively identified 4 consecutive cases of apocrine cystadenomas in male patients with a mean age of 48.5 years (range 20–62). One of the cases was a recurrent lesion. The Preoperative clinical diagnosis was mostly hidrocystoma. All patients agreed on complete surgical excision of their cystic lesions. Histopathological review of the excised cysts confirmed the diagnosis of apocrine cystadenoma based on the presence of proliferative features with no atypia or infiltrative behavior. Cases are summarized in Table 1 and the histopathological appearance is demonstrated in the included figure. DiscussionApocrine cystadenoma is rare. It occurs in the areas of skin with hair follicles, such as the axilla, neck, and trunk, and may be mistaken for other skin lesions, such as nevi or syringomas. In the eyelid region, they are commonly missed and frequently diagnosed as simple hidrocystoma due to the presence of bluish hue such as in our series. Recurrence is rare but was found in one of our patients at initial presentation. Our series included unique locations of this lesion in the medial canthus in one patient and near the eyelid tarsus in another. ConclusionOphthalmologist should be aware of the rare occurrence of this lesion in the periocular region. Further studies to explain the etiology of such proliferative nature in apocrine cysts would be interesting.

A case report of tubular apocrine adenoma of lower eyelid

Moll glands are sweat apocrine glands close to the eyelid margin. Tumors derived from Moll glands are rare, although Moll glands cysts are frequent. They originate from their glandular tissue or tubules. In this report we present a rare case of a lower eyelid skin tubular apocrine adenoma occurred in the right eye lower eyelid of a caucasian 45 year old woman. The lesion was nodular and dome shaped and its size was 1.5 × 3.5 × 2 mm. After a complete excision the lesion was analyzed by our pathology unit. Histologic sections were stained with haematoxylin and eosin, alcian blue, periodic acid-Schiff (PAS). Additionally, the following immunohistochemical markers were used: cytokeratin 7 (CK7), cytokeratin 8/18 (CK8/18), cytokeratin 20 (CK20), S-100 protein and gross cystic disease protein 15 (GCDFP-15) (4,5). The immunohistochemical and phenotypic features resulted suggest the diagnosis of lower eyelid tubular apocrine adenoma probably originated from Moll glands. These findings allowed us to diagnose a very rare and benign cutaneous lesion of eyelid skin.

Anatomical and Histological Study of the Upper Tarsus in Asian.

The aim of this study was to observe and analyze the anatomical and histological characteristics of the upper tarsus in Asian. A total of 15 Asians (14 adults, 1 child) were used. The sagittal sections with thickness of 3μm in the middle of the upper eyelid were prepared and stained with hematoxylin-eosin, Masson trichrome and anti-smooth muscle actin antibody staining, and then were observed and photographed under light microscopy. On the sagittal section, the upper end of the tarsus was connected with the Müller muscle and the part of the posterior layer of the levator aponeurosis; the lower end was the inflated part of the palpebral margin; the superficial surface was connected with the pretarsal fascia; and the deep surface was connected with Müller muscle aponeurosis and palpebral conjunctiva. Histologically, the tarsus was similar to the structure between dense fibrous connective tissue and cartilage, and its main structures include meibomian glands and its ducts, accessory lacrimal glands, glands of Moll, glands of Zeis, eyelash hair follicles, Riolan muscle, blood vessels, and collagen fibers. Through the observation of the tarsus of a child, compared with the adult specimen, the meibomian gland tissue was more abundant; the collagen fibers density was significantly lower and arranged orderly; the blood vessel density was significantly higher; α-SMA positive smooth muscle cells could be seen in the upper end of the tarsus and its superficial and deep surfaces. In this study, the internal and adjacent anatomical structures of the upper tarsus in Asians were observed under a microscope, and according to the histological characteristics, the tarsus was divided into 3 parts and 3 types. Through the preliminary analysis, the tarsus was likely to show different histological characteristics in different individuals and age groups of Asians. There was a certain correlation between the degree of meibomian gland atrophy, the degree of collagen fibrosis and the density of blood vessel in the tarsus.

CHONDROID SYRINGOMA :A RARE UPPER EYELID TUMOR

Chondroid syringoma is a benign adnexal mixed tumor of skin characterized by sweat gland elements in a cartilaginous stroma1. It is a tumor found to be arising from the sweat glands which can be apocrine (found throughout the surface of lid) or eccrine (glands of moll) with a mean age of 50 years2. Chondroid syringoma is a rare benign tumour that accounts for 0.01% of all primary skin tumours3 and occurs rarely in the upper eyelid region. Head and neck region involvement is common (nose is the most common site).It is morphologically similar to pleomorphic adenoma or benign mixed tumour of the salivary gland4. A 18-year-old male patient presented to us with a slow growing, painless mass on right upper eyelid since 6 months. Complete surgical excision of the mass was done under local anaesthesia. This report aims to discuss about this rare benign tumor of the eyelid and to study the histopathological aspects of it.

A rare case of congenital ectopic eyelid tissue

Ectopic eyelid, an extremely rare entity, is a congenital disturbance in embryogenesis in which lid tissue is present in an abnormal position near the eyelid. We herein report a case of a six-year-old child with a soft mass near the lateral canthus of the left eye having cilia overlying it, with a similar family history in her father. A surgical excision biopsy was performed under general anesthesia. A histopathology report revealed stratified squamous epithelium with numerous dermal pilous units consisting of a central hair shaft and clusters of Moll's glands, suggesting eyelid tissue. Therefore, an ectopic eyelid tissue can be considered a differential diagnosis for any congenital, non-progressive, soft tissue mass near the eyelid with overlying cilia. However, histopathology is required to confirm the diagnosis.

A case of adenocarcinoma (not otherwise specified) occurring in the molar glands

A case of adenocarcinoma (not otherwise specified) occurring in the molar glands

The lowly chalazion

Chalazia are localized cysts of chronic lipogranulomatous inflammation arising from the obstruction of sebaceous glands of the eyelid tarsal plate, including the Meibomian gland (deep chalazion) or Zeis gland (superficial chalazion). This disease entity is differentiated from the hordeolum (stye), an acute purulent localized swelling of the eyelid often associated with an eyelash follicle, Zeis gland, or Moll gland obstruction and infection. Ambiguously, the chalazion, hordeolum, and blepharitis are commonly categorized and described on a continuum in the literature. While it is one of the most common eyelid disorders across all age demographics, the chalazion remains largely understudied and pathophysiological, epidemiological, and therapeutic findings exist fragmented in the literature. We discuss current understandings of the chalazion and provide current best practice guidelines supported by clinical anecdotal evidence.

Immunohistochemical detection of urea transporter-A in the tear-producing part of the lacrimal system

ObjectiveUrea constitutes a physiological and presumably well-regulated constituent of tear fluid. Its lacrimal concentration is significantly decreased in dry eye disease. Urea homeostasis within the tear fluid may also depend on the expression of urea transporters. The present study reports on the expression patterns of urea transporter A (UT-A) in the cells and tissues of the ocular surface and the lacrimal glands. MethodsUT-A immunohistochemistry was performed on 5 µm paraffin sections of paraformaldehyde-fixed human, porcine, and murine corneas, eyelids, and lacrimal glands (n = 5 each). ResultsUT-A immunostaining was largely comparable in all three species. UT-A signals were detected in the corneal epithelium and endothelium, in the conjunctival epithelium, in the acinar cells and excretory ducts of the lacrimal gland, Meibomian gland, and in the glands of Moll and Zeis. The Meibomian glands and the glands of Zeis exhibited a marked UT-A-positive staining in the basal cells of the alveolar epithelia and in the ductal epithelia. ConclusionUT-A shows comparable expression patterns to UT-B (previous study) at the ocular surface and in the lacrimal glands, as determined by immunohistochemistry. The presence of both urea transporters in the lacrimal functional unit suggests that they are essential for the normal function of the lacrimal system and the integrity of the tear film. Potential alterations in urea transporter expression might be associated with the significant reduction of urea found in the tear fluid of dry eye patients. They may thus play an important role in the pathogenesis of dry eye disease.

Morphological evaluation of the orbit and peri-ocular glands of the African grasscutter (Thryonomys swinderianus)

The morphological features of the orbit and peri-ocular glands of the herbivorous African grasscutter were evaluated in this study. Heads of the rats were processed using the cold-water maceration technique, while the peri-ocular glands were obtained and processed for light microscopy using the conventional paraffin technique. The orbit was laterally located and associated with an enlarged maxillary infraorbital foramen. This orbital configuration imparted the grasscutter with a panoramic field of vision and a hystricomorphous improved masticatory ability. The Zeis and meibomian glands were located in the eyelid and showed holocrine histological features with myoepithelial cells surrounding their secretory acini. The gland of Moll was a simple coiled tubular gland that, together with the gland of Zeis, were associated with the palpebral cilia. The large harderian gland situated posterior to the eyeball was a lobulated compound exocrine gland whose secretory cells contained basally-displaced nuclei and foamy cytoplasm. The protruding glandular mass located adjacent to the rostral half of the upper eyelid, which we named the suprapalpebral gland had similar histological features as the harderian gland. These peri-ocular glands produced mainly mucoid and lipid secretions required for maintenance of structural and functional integrity of the cornea and eyelid. The qualitative and quantitative data from this study will be useful in the understanding of the biology of the African grasscutter and in the identification of orbital and peri-ocular glandular pathology in this species.

Urea transporter-B expression on the ocular surface and in the lacrimal glands

ObjectiveUrea is a component of tear fluid showing a significantly decreased concentration in dry eye disease. The urea content of tear fluid may depend on urea transporters. The purpose of this study was to examine the expression of urea transporter B (UT-B) at the ocular surface and in the lacrimal glands. MethodsUT-B protein and mRNA expression was investigated in human, porcine, and murine samples. Immunohistochemical staining for UT-B was performed on paraffin sections of human, porcine, and murine corneas, eyelids, and lacrimal glands (n = 5 each). Reverse transcriptase polymerase chain reaction was conducted to detect UT-B mRNA in human and murine cornea, conjunctiva, Meibomian gland, and lacrimal gland (n = 5 each). ResultsUT-B protein expression was comparable in all three species. It was found in the corneal epithelium and endothelium, in the conjunctival epithelium, in the end pieces and excretory ducts of the lacrimal gland, Meibomian gland, and in the glands of Moll and Zeis. The glands of Zeis and the Meibomian glands showed intense UT-B signals in the basal layers of the alveolar epithelia and in the cells of the ductal epithelia. UT-B mRNA was detected in all samples analyzed. ConclusionUT-B is expressed by the cells and tissues of the ocular surface and in the lacrimal glands. Potential changes in urea transporter expression might have implications for the pathogenesis of dry eye disease. Since comparable results were obtained for all species investigated, the presented findings may open the door for DED-relevant experimentation on porcine and murine model systems.

Pleomorphic adenoma of the palpebra: a histopathological case report

Pleomorphic adenoma (PA) is a benign glandular tumor, originating most commonly from the parotid gland. Other rare locations for PA are the breast, lung, lacrimal glands, etc. PA originating from other exocrine glands such as the glands of Moll in the palpebra are extremely rare. Herein we report a case report of a 66-year-old female patient with such PA, excised due to vision impediment, with a discussion on the histological aspects and diagnostic and management approaches of PA in this rare location.

Motilin Receptor Expression Found in the Human Main and Accessory Lacrimal Glands

ABSTRACT Introduction: In this study, we investigated the presence of motilin receptors (MR) in adnexal tissue including the human main lacrimal gland. Method: 17 adnexal human specimens comprising of 11 isolated human main lacrimal gland specimens, four full-thickness human eyelid excisions and two exenterations containing full-thickness eyelid and portions of the main lacrimal gland were immunolabelled with a rabbit polyclonal human MR antibody. Results: Our results demonstrated that all main lacrimal gland specimens (13/13, 100%) were positive for MR expression with a predominance (10/13 (77%) of grade 1+ punctate distribution. Motilin receptors were not found in eccrine glands, cutaneous sebaceous glands, glands of Zeis or glands of Moll (0/6, 0%). We also confirmed MR expression in the accessory lacrimal gland tissue. Conclusion: In summary, we discovered the MR receptor in the lacrimal and accessory lacrimal gland - the significance of which, in the lacrimal gland, remains unclear - but motilin may play a role in the muscarinic control of aqueous tear secretion.

18435 Extramammary Paget disease of the eyelid with clivus malignancy

Extramammary Paget disease (EMPD) was originally described in 1889 by Crocker, who reported genital lesions histologically similar to those described by Paget in 1874. EMPD is a rare intraepithelial adenocarcinoma that affects body parts with abundant apocrine glands. Primary form is the most common, originating in the epidermis or cutaneous adnexa. Secondary form, less often, occurs in association with an underlying malignancy, usually of the lower gastrointestinal or urinary tract. EMPD is an uncommon neoplasm, which occurs mostly in the anogenital region, but can arise in other areas of skin or mucosa. It comprises 2% or less of primary vulval neoplasms and is even rarely in other sites. There are reports of EMPD arising in other areas, such as axilla and ear. The first description of EMPD of the eyelid was made by Hagedoorn in 1937, related with previous trachoma and posterior developing of eyelid carcinoma. After that, Whorton described in 1955 a case of EMPD of the eyelid related to carcinoma of Moll glands. The purpose of this report is to describe a case of EMPD of the eyelid in a 60 year female patient, who was also diagnosed with clivus malignancy. She presented an erythematous, exulcerated and squamous lesion on the ocular area, eyelids and cheek. Histologic analysis showed EMPD disease from different samples.There were scars, caused by previous surgeries, and an eye prosthesis after the treatment of clivus malignancy. Besides the lesion extension, she also presents undefined intracranial lesions and the treatment plan is a challenge.

A CASE STUDY ON ANJANANAMIKA W.S.R TO STYE

Stye is an infection of the sebaceous glands of zeis at the base of the eye lashes, or an infection of the apocrine glands of moll. In Ayurvedic science, based on clinical signs and symptoms, stye can be correlated to Anjananamika where the symptoms include Dahatodavatitamrapidaka– i.e., boil which will be in Tamravarna associated with burning sensation and pricking sensation at Vartmapradesha i.e., in the lid and the other symptoms includes Mridvimandaruja– it will be soft and associated with mild pain. The line of treatment of the disease Anjananamika (stye) includes Swedana (hot compress), Nishpidana (pressure applying to drain out pus), Bhedana (incision), Pratisarana (rubbing of medicaments over the lids), Anjana (collyrium). The objective of the present study is to evaluate the effect of Bidalaka and Aschyotana along with internal medicines. A 19-year female patient approached the Shalakya tantra OPD of Sri Paripoorna Sanathana Ayurveda Medical College, Hospital and Research centre, Nelamangala, Bangalore with the complaints of swelling in the left eye lid since 3 days with mild pain and redness of the eyes. On examination, the whole edge of the left eye lid was oedematous along with the presence of an abscess in outer canthus. On these signs and symptoms, the patient was diagnosed as a case of stye and advised Kriyakalpa based on the Roga and Rogibala along with internal medicines which have given promising results with the complete absence of the symptoms within 10 days.

Anatomical characteristics of the major salivary glands of puma (Puma concolor Linnaeus, 1771)

Abstract The morphological knowledge of the salivary glands in wild species is fundamental, since these studiescan be used as conservation strategies, clinical treatments and the preservation of species threatened with extinction. Thus, the aim of the study was to anatomically describe the larger salivary glands: parotid, mandibular, sublingual and molar of the jaguar. For this, two specimens of puma (Puma concolor) were used, after death by road traffic accident, donated by the Clinical Surgical Service Department of the Veterinary Hospital “Dr. Halim Atique “(UNIRP). The animals were fixed with 10% aqueous formaldehyde solution, dissected, descriptively analyzed and photographed. Morphologically, the parotid gland is grayish-yellow in color, distinctly lobulated, and has a semilunar shape. This gland is located in the posterolateral region of the face and at its ventral end we observe the parotid duct. The mandibular gland presents a slightly rounded outline, a grayish color and its surface is covered by a capsule of connective tissue. This gland is located in the posterolateral region of the face and we find the mandibular duct at its ventral end. The monostomatic sublingual gland is located on the rostral border of the mandibular gland and it is covered by the mandibular lymph nodes. The molar gland is a yellowish-gray membranous protuberance, elongated, with rectangular shape and it lies dorsally to the labial commissure. Based on the dissections, we conclude that the morphological and topographic characteristics of salivary glands of puma follow the same structural pattern described for other species of carnivorous mammals (domestic and wild).

Solid Variant of a Proliferative Apocrine Hidrocystoma

A cystic lesion of the eyelid margin in a 37-year-old man was diagnosed clinically as an apocrine hidrocystoma, a common lesion in that location. Histopathologic examination confirmed the presence of a hidrocystoma but also disclosed an extensive proliferation of bland epithelial cells arising from the inner layer of the cyst. The authors further characterized this unique occurrence on the spectrum of Moll gland eyelid tumors by immunohistochemical analysis.

HMG-CoA reductase expression in human eyelid tissue and in a human meibomian gland epithelial cell line.

3-Hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGCR), the rate-limiting enzyme of cholesterol production, has been found to contribute to lipid secretion from skin sebaceous glands and hair follicles. We assessed for HMGCR expression in human eyelid tissue and in immortalized human meibomian gland epithelial cells (HMGECs) using immunohistochemistry. Full thickness human eyelid specimens in archival paraffin blocks were obtained. A section from each block was stained with hematoxylin and eosin and examined by an ocular pathologist for validation of tissue pathology. Immunohistochemistry was performed using rabbit anti-human HMGCR antibody on serial sections using the Ventana automated staining system. HMGCR expression was examined for in HMEGCs with fluorescence immunocytochemistry and confocal microscopy. Thirteen full thickness eyelid specimens met the inclusion criteria. All specimens contained meibomian glands, and 2 (15%) contained glands of Zeis, 3 (23%) pilosebaceous glands, 2 (15%), accessory lacrimal glands, and 2 (15%), glands of Moll, respectively. Immunohistochemistry showed HMGCR expression in meibocytes of meibomian glands and sebocytes of Zeis and pilosebaceous glands in all specimens. HMGCR expression was also evident in vascular endothelium. Immunofluorescence was positive for HMGCR expression on HMGEC cells. No labeling was seen for the negative Ig control. HMGCR was expressed in all eyelid sebaceous-type glands and in HMGECs, consistent with a role for cholesterol production in the genesis of tear film lipids. The observed expression also provides a rationale for using topical statins, inhibitors of HMGCR, as novel tear film lipid stabilizers in conditions such as blepharitis, where meibum production is aberrant.

Differential Incidence of Eyelid Margin Cysts in ASU Outpatients

Background: Wide varieties of lesions affecting the eyelid are encountered within routine Ophthalmology practice. These lesions are numerous due to the unique anatomical features of the eyelid as the whole skin structures, appendages, muscle, modified glands, and conjunctival mucous membrane are represented in the eyelid. The eyelid comprises different types of glands that clinically correlate with the development of eyelid cysts; Sebaceous glands (Meibomian glands and glands of Zeis), aporcine glands (glands of Moll) and eccrine sweat glands. Objectives: To report the incidence of the different etiologies of eyelid margin cysts in Ain Shams University (ASU) Hospital, General Ophthalmology Outpatients Clinic. Patients and Methods: It included all patients who presented to the General Ophthalmology Outpatient Clinic, 6 days per week for one month (November 2017) complaining of eyelid margin lesions, found cystic on slit lamp examination, of all ages. Results: The total number of patients recorded was 45 patients presenting with eyelid margin cysts, out of 1920 patients visiting the General Ophthalmology Outpatient Clinic during the month of November 2017 with an incidence of 2.34%. Seven types of cysts were found namely; External Hordeolum (8.9%), Internal Hordeolum (15.6%), Chalazion (28.9%), Sebaceous Cyst (11.1%), Cyst of Zeis Gland (13.3%), Apocrine Hidrocystoma (11.1%) and Eccrine Hidrocystoma (11.1%). Conclusion: Eyelid margin cysts should be studied and categorized as a separate entity from eyelid lesion due to the unique anatomy of the eyelid margin. The incidence was calculated to be 2.34% during this study that was relatively short lived. Chalazion was the most common lesion encountered but that was solely by clinical diagnosis. Recommendations: It is recommended to continue this study for a longer duration to be more comparable with the other studies and it should be enriched by histopathological diagnosis aside the clinical one.

Congenital sudoriferous cyst of the orbit: A case report and review of literature

Apocrine gland cyst (sudoriferous cyst and apocrine hidrocystoma) is fairly uncommon in the eyelid, where it derives from the apocrine glands of Moll. In rare instances, an apocrine gland cyst can occur in the anterior portion of the orbit. If an orbital cyst affects the globe or extraocular muscles, it should be excised as soon as possible to prevent strabismus and amblyopia. Herewith, we are presenting the case of sudoriferous cyst in a 9-year-old child managed with surgical excision.

Eyelid Apocrine Hidrocystomas in a Cat

Background: Eyelid apocrine hidrocystoma (AH) is a benign cystic lesion originating from the glands of Moll. These eyelid lesions are rare in cats and there are few cases reported in the literature. The aetiopathogenesis of AH is unknown and the lesion has been interpreted either as proliferative adenomatous tumour or as retention cyst. Defnitive diagnosisrequires biopsy with microscopic examination. Treatment options for eyelid AH include surgical excision, drainage through aspiration, cryosurgery with liquid nitrogen and chemical ablation. The aim is to report a case of bilateral multiple AH of the eyelids in a cat that was successfully treated with surgical excision.Case: A 5-year-old male Himalayan cat was referred to the Ophthalmology Section in the Veterinary Clinics Hospital of the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil with a history of pigmented masses in both eyes that had been progressively enlarging over a 1-year period. Ophthalmic examination revealed two cysts on themedial canthus at the eyelid margin in both eyes. In the left eye was observed mild blepharospasm and lacrimation. Cysts were soft, smooth, round and flled with a dark brownish pigment. The remainder of the ophthalmic examination was unremarkable. Surgical excision of the cysts was indicated with a safety margin. The surgical procedure was performedunder inhalation anaesthesia using an operating microscope. A V-shaped, full-thickness excision of the eyelid containing the cyst was performed. The eyelids were closed with two layers of sutures. No complications were noted during surgery. Microscopic examination revealed cystic dilatation of the sweat glands with a large amount of eosinophilic secretion. EyelidAH was diagnosed based on the results to confrm the diagnosis. The cat recovered and was discharged the following day. The postoperative treatment involved the administration of tramadol (2 mg/kg, PO, q 12 h) daily for 3 days. After surgery, the cat had no signs of ocular discomfort. After three years, no recurrence has been observed.Discussion: AH is a benign tumour derived from Moll’s glands. The exact aetiology of AH is unknown. A breed-specifc predisposition among Persian cats has been suggested. In the present case, the ophthalmic examination revealed periocular masses brownish to black, round, soft, and fluid-flled. Multiple pigmented nodules involving the skin of the lower eyelids were observed. In the current case, the cat was of the Himalayan breed and was 5 years old with multiple AH in both eyelids. In terms of clinical features, this case was similar to previous ones reporting eyelid AH in cats. Normally, a defnitive diagnosis is confrmed through histopathology after excisional biopsy. In the current case, diagnose was made on the basis of the clinical fndings, history, and results of histological examination. Treatment options for eyelid AH include surgical excision, aspiration, cryosurgery and chemical ablation with trichloroacetic acid. Surgical removal of the cysts was performed in the current case. Histopathologic examination revealed cystic dilatation of the sweat gland with large amount of eosinophilic secretion. The sutures were removed one week after surgery. Periodic evaluations were conducted and there were no signs of recurrence after three years. In the present case, surgical excision was effective in the treatment of eyelid AH in a cat.Keywords: lid, cystic adenomas, feline.