Apocrine Adenocarcinoma of the Eyelid: A Diagnostic Challenge in Apparently Benign Lesions
Author: Alvaro Ferragut-Alegre
Base Hospital / Institution: Institut Català de la Retina
ePoster presentation
Abstract ID: 25-559
Purpose
To present a rare case of apocrine adenocarcinoma of the eyelid, highlighting the importance of clinical suspicion and appropriate surgical management.
Methods
Comparative, prospective case report and and literature review. A 72-year-old man with prostate and colon cancer presented with a 3-week reddish nodule lesion in the left upper eyelid which was excised as a chalazia. During the follow-up after surgery, the tumour had almost triplicated its size, conditioning a mechanical ptosis. Neither diplopia nor proptosis were present. An excisional biopsy with a 3 mm security margin resection was performed.
Results
Histopathology showed wide epitelial cells with eosinophilic cytoplasm and atypical nulcei forming gland-like structures . The luminal cells demonstrated decapitation secretion. Immunohistochemical testing for EMA (Epithelial Membrane Antigen), CEA (Carcinoembryonic Antigen) and CK7 (cytokeratin 7) was positive. An Apocrine Adenocarcinoma diagnostic was stablished and an orbital computed tomography (CT) was requested, which discarded intraorbital invasion.
A week later a second surgery was performed, resection of the affected margins and the eyelid reconstruction was done with auricular cartilage graft and conjunctival flap advancement.
Conclusion
Apocrine adenocarcinoma of the eyelid is a rare neoplasm with potentially aggressive behavior. It may clinically mimic benign or inflammatory lesions such as chalazion, leading to diagnostic delays. Histopathological analysis is essential for an accurate diagnosis. Surgical excision with adequate margins and close follow-up are recommended to monitor for recurrence or metastasis. To the best of knowledge, there are only 28 reported cases of apocrine adenocarcinoma of the eyelid.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Pilar | Peña Urbina | Institut Català de la Retina |
| Marta | Balboa Miró | Institut Català de la Retina / Hospital Universitari Germans Trias i Pujol |
| Nuria | Ibáñez Flores | Institut Català de la Retina |
