Papillary hidradenoma of the eyelid margin: clinical and immunohistochemical observations further supporting an apocrine rather than an eccrine origin

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.

Cytokeratin expression in epidermal stem cells in skin adnexal tumors

The expression levels of seven types of cytokeratin (CK) in different kinds of skin adnexal tumors were evaluated. One hundred and thirty-two patients with different kinds of skin adnexal tumors admitted and treated in the Department of Dermatology of Dongying People's Hospital from May 2013 to May 2015 were selected and underwent tissue section staining. Another 20 cases of normal skin were enrolled as the control group. The expression levels of the seven types of CK in different kinds of skin appendages were observed and recorded. The expression levels of the seven types of CK in the 132 cases of skin adnexal tumor tissues were different. CK10 was mainly expressed in squamous cell carcinoma, but it was not expressed in basal cell carcinoma. CK19 was expressed in basal cell carcinoma, but its expression was not detected in squamous cell carcinoma. As the degree of differentiation was increased in the epidermis, hair follicle and sebaceous gland, the expressed molecular weight of CK was augmented gradually. The expression levels of five types of CK (namely, CK8, CK10, CK14, CK18 and CK19) could be measured in the squamous cell carcinoma and basal cell carcinoma. Statistical analysis revealed that there were statistically significant differences in the expression levels of these five types of CK in the two cell carcinomas (P<0.05). Five types of CK, i.e., CK7, CK8, CK17, CK18 and CK19, had markedly different expression levels in hair follicle tumor and sweat gland tumor, which were statistically significant (P<0.05). The expression levels of a group of CKs detected by virtue of semi-quantitative analysis via immunohistochemistry can be regarded as one of the important indexes for clinical diagnosis of skin adnexal tumors.

Ectopic Tubular Papillary Apocrine Adenoma on the Eyelid: A Case Report of Misleading Clinical Presentation and Location

We report the case of a 38-year-old patient with a tubular apocrine adenoma with papillary differentiation. The clinician was challenged in her diagnosis by the initially misleading appearance and ectopic location. Histopathological findings and immunohistochemistry delivered conclusive proof for the correct diagnosis. Therefore, it is important for the ophthalmologist to request histopathological analysis to diagnose and differentiate from malignancy. A complete local excision is recommended to prevent recurrence.

Eyelid syringocystadenoma papilliferum: A novel presentation with major review

A major review of the literature of syringocystadenoma papilliferum's (SCAP's) presentation and management is presented. In addition, a case report of this unique diagnosis presenting as a corneal abrasion in a 66-year-old-male is included. This benign adnexal tumor of the apocrine glands is most commonly found in the face and neck. When found on the eyelids, these lesions are commonly misdiagnosed as basal cell carcinoma or cysts. Diagnosis is made based on histopathology. Treatment is complete excision of the lesion and this has a low recurrence rate. While predominantly benign, there have been cases of basal cell carcinoma development or other malignant transformations. Of the 26 reported cases of SCAP of the eyelids, none have caused a corneal abrasion. The authors present the only known presentation of eyelid SCAP, causing corneal abrasions, and provide a review of literature with discussion of clinical presentation, natural history, diagnosis, and treatment of this rare, eyelid lesion with potential for malignant transformation.

Hidradenoma Papilliferum With Oncocytic Metaplasia: A Histopathological and Immunohistochemical Study

Hidradenoma papilliferum is a benign cutaneous adnexal neoplasm, commonly occurring in the vulva and perianal region of adult women. It has characteristic histopathological features composed of anastomosing and branching tubules, lined by columnar cells, and a basal layer of myoepithelial cells. A 39-year-old woman was evaluated for 2 asymptomatic labial masses. The histopathological examination revealed a Bartholin's cyst and a hidradenoma papilliferum. The latter contains a distinct area of oncocytic/oxyphilic metaplasia. Immunohistochemical stains revealed positive staining for gross cystic disease fluid protein (GCDFP)-15 and androgen receptor. GATA-3, a protein expressed in sweat glands, highlights a similar positive staining pattern with weaker staining in areas of oncocytic metaplasia. P63 highlighted the myoepithelial differentiation. In situ hybridization for Human Papilloma Virus 6, 11, 16, and 18 was negative. P53 was negative and Ki-67 was low, confirming its benign nature. Oncocytes are enlarged epithelial cells with voluminous eosinophilic granular cytoplasm resulting from staining of nonribosomal cytoplasmic components. Few reports documented it in hidradenoma papilliferum. Our case demonstrated a florid distinct appearance of this metaplasia. The immunoprofiles of this oncocytic metaplasia such as p53 negativity and positivity for androgen receptor and GCDFP-15 demonstrates similarity to apocrine metaplasia in the breast. The authors' case demonstrates the benign nature of oncocytic metaplasia and supports the common origin of oncocytic cells and columnar cells in hidradenoma papilliferum.

A case of syringocystadenoma papilliferum of eyelid with literature review

Syringocystadenoma papilliferum can rarely affect eyelid skin. The lesion is frequently misdiagnosed as basal cell carcinoma or cyst or squamous cell carcinoma. We are presenting a case that was clinically diagnosed as basal cell carcinoma of eyelid but was later histologically diagnosed as syringocystadenoma papilliferum.