Lurking in the lids: A Case Series of Endocrine Mucin-Producing Sweat Gland Carcinoma
Author: Namita Mathews
Base Hospital / Institution: Manchester Royal Eye Hospital
ePoster presentation
Abstract ID: 24-508
Purpose
Endocrine Mucin-Producing Sweat Gland Carcinoma (EMPSG) is a rare cutaneous tumour that has a predilection for the periocular region. This tumour presents a diagnostic dilemma to the oculoplastic surgeon as its presentation can mimic benign lid lesions. In addition, the histology is analogous to ductal carcinoma of the breast and mammary solid papillary carcinoma. The removal of benign lid lesions is not routinely funded on our health system therefore these lesions may go untreated. We herein present a series of 6 cases of EMPSG to highlight clinical characteristics of the tumour.
Methods
A retrospective review of 6 EMPSG cases presenting between 2021 and 2024 to Manchester Royal Eye Hospital and Lancaster Teaching Hospitals was conducted. Patient demographics, presenting complaints, examination findings, histopathology, and pre-operative clinical images were obtained from patient records.
Results
83% of patients were female with an average age of 70 (range 56-80 years). No patients had a history of breast cancer. The pre-biopsy diagnosis was hidrocystoma in 5 out of the 6 cases. Prior to biopsy EMPSG was not considered as the working diagnosis in any of the cases. Lesions had been present between a range of 3 months to 5 years. Rapid growth was only seen in 1 case but there was documented growth in 3 patients. Patients were initially treated with either incisional biopsy/excisional biopsy. Following the pathological diagnosis all patients were discussed at the Dermatology Multi-disciplinary Team (MDT) and further excision with margins was recommended.
Conclusion
Whilst rare, our series highlights the importance of considering EMPSG in the differential diagnosis of periocular lid lesions. In particular, EMPSG should be considered in older women presenting with hidrocystomas increasing in size. Finally, the series highlights the importance of sending all tissue for a histopathological diagnosis even if pre-biopsy, the lesion is considered to be benign.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Varsha | Kadaba | Manchester Royal Eye Hospital |
| Anne | Cook | Manchester Royal Eye Hospital |
| Adam | Bull | Manchester Royal Eye Hospital |
