ASOPRSFall Scientific SymposiumSyllabus
23
YASOPRSEyeOpeners—RapidFireCases andPresentations
Sponsored byYoungASOPRS (YASOPRS).YASOPRS are defined asASOPRSmembers, age 40 or less.
Moderators:Albert Ya-PoWu,MD, PhD, Shu-HongChang,MD
7:00 am
ACyst YouDon’tWant toMiss: EndocrineMucin-ProducingSweatGland
Carcinomaof theEyelid
Nada Farhat
1
, Rachel Sobel
2,3
, Avneet Sodhi
1
, KatrinkaHeher
1
, JuliaSchneider
3
,MiteshKapadia
1
, Nora Laver
1
.
1
Department of
Ophthalmology, TuftsMedical Center, Boston,MA, UnitedStates,
2
Department of Ophthalmology, BostonMedical Center, Boston,MA,
UnitedStates,
3
BostonUniversitySchool ofMedicine, Boston,MA, UnitedStates
Introduction:
Endocrinemucin-producing sweat gland carcinoma (EMPSGC) is an uncommon slow growing intradermal tumor that
can occur in the eyelid.This low-grade tumor has been reported in other anatomic sites including the breast and vulva. Due to limited
number of case reports, clinical and histopathological diagnosis of this tumormay be under recognized.This study aims to report the
clinical presentation and outcomes of patientswith EMPSGC and discuss the best treatment strategies for clinicians.
Methods:
In-depth retrospective review of clinical and pathologic informationwas performed on 16 cases of EMPSGC, from
2000-2014, the largest case series to date. Immunohistochemistry for synaptophysin, chromogranin, estrogen receptor (ER),
progesterone receptor (PR) and e-cadherin stainswere performed on formalin-fixed paraffin-embedded tissue.Mucicarmine stain
was also performed in all cases.
Results:
Themajority of patients (69%) presentedwith a slow growing cystic eyelid lesion. Other presentations included a nodular,
papular or elevated erythematous lesion. It most commonly occurred in females (81% of cases) and in the lower eyelid (62% of
lesions). Other sites included themedial canthus (6% of cases) and the upper eyelid (32% of cases). Seventy-five percent of cases
required excision.After the initial biopsy; one case required re-excisionwith clearmargins due to recurrence three years later; none
of the cases showedmetastases. Invasive carcinoma infiltrating the reticular dermiswas found in 2 cases. Of interest, 2 patients
were also diagnosedwith ductal carcinoma of the breast. Histopathology of all eyelid tumors showed a cyst with solid, papillary,
andmicropapillary tumor growth patterns.All eyelid tumors showedmucin production,with immunoreactivitywith neuroendocrine
markers (synaptophysin and chromogranin) and ER/PR positivity.
Conclusions:
Surgeons should biopsy cystic appearing lesions of the eyelid despite their benign appearance in order to identify
occult EMPSGC. Complete excision of EMPSGCwith clearmargins is recommended to avoid recurrences and transformation to
invasivemucinous carcinoma.The relationship between EMPSGC and breast carcinoma deserves further investigation, given the
analogous histopathology and presence of concomitant disease.
References:
Hoguet A,WarrowD,Milite J,McCormick SA,Maher E, Della Rocca R, Della RoccaD, GoldbaumA,MilmanT.
Mucin-producing sweat gland carcinoma of the eyelid: diagnostic and prognostic considerations.Am JOphthalmol. 2013
Mar;155(3):585-592.
Shimizu I, Dufresne R, Robinson-Bostom L. Endocrinemucin-producing sweat gland carcinoma. Cutis. 2014 Jan;93(1):47-9.
BulliardC,Murali R,Maloof A,Adams S. Endocrinemucin-producing sweat gland carcinoma: report of a case and review of the
literature. J Cutan Pathol. 2006Dec;33(12):812-6.
Dhaliwal CA,TorgersenA, Ross JJ, Ironside JW, BiswasA. Endocrine
mucin-producing sweat gland carcinoma: report of two cases of an under-recognizedmalignant neoplasm and review of the
literature.Am J Dermatopathol. 2013 Feb;35(1):117-24.
DetailedProgram
—Thursday,October 16, 2014
