Small cell neuroendocrine carcinoma of the eyelid.

This is a case presentation of a rare primary small cell neuroendocrine carcinoma of the eyelid. This tumor was diagnosed and differentiated from Merkel cell carcinoma using histopathology, immunohistochemistry, and electron microscopy.

Histiocytoid eccrine sweat gland carcinoma of the eyelid: report of a case.

This report describes the 12th documented case of histiocytoid, diffuse or signet-ring cell eccrine sweat gland carcinoma of the eyelid, a rare neoplasm that characteristically affects older men and mimics distant metastasis. Clinically, the patient was thought to have a colonic metastasis. Histologically, the neoplasm comprised sheets and cords of polygonal, eosinophilic cells, with dispersed larger, rounded single cells resembling histiocytes, and cells with cytoplasmic lumina or a signet-ring appearance. Occasional duct formation was also seen. The features were reminiscent of both the histiocytoid and lobular variants of breast carcinoma. Ultrastructurally, the presence of nonintestinal type microvilli with a length : width ratio in excess of 16 were consistent with an eccrine origin, but also raised the possibility of metastatic mesothelioma. However, a metastatic lesion was excluded by clinical and imaging investigations. There has been no recurrence 3 years after primary excision.

[Merkel cell carcinoma]. / Le carcinome de Merkel.

Merkel cell carcinoma is a neuroendocrine tumor of the skin, originating from neuroendocrine cells. A case report of Merkel cell carcinoma, discovered in a 77-Year-old woman, was diagnosed and confirmed on a biopsy. Diagnostic and therapeutic orientations of this unusual but malignant tumor are described.

[Primary signet ring cell carcinoma of the eccrine sweat gland in the eyelid. Immunohistochemical and ultrastructural study of a case]. / Adénocarcinome sudoral primitif de la paupière de type eccrine à cellules en bague à chaton.

We report a case of a 45-year-old woman who exhibited a primitive eccrine sweat gland carcinoma of the eyelid. Histological study showed cellular proliferation with an Indian file pattern and some signet ring cells with sialomucin secretion. Immunohistochemical study demonstrated these cells to be positive with the anticytokeratin, anti-EMA, anti-HMFG, antiestrogen receptor and antiprogesterone receptor antibodies. Ultrastructural study showed intracytoplasmic vacuoles with numerous microvilli at the apical side. Differential diagnosis with a metastasis from a mammary adenocarcinoma is difficult and a complete staging is necessary to confirm the primitive origin of the tumor. The behavior of this tumor is marked by locoregional recurrence.

Giant cell angiofibroma of the orbit and eyelid.

PURPOSE: To report the clinicopathologic features of a newly recognized tumor, giant cell angiofibroma. DESIGN: Observational case series. MAIN OUTCOME MEASURES: Clinical and histopathologic features of giant cell angiofibroma. METHODS: Light and electron microscopy and immunohistochemistry of five cases of giant cell angiofibroma. RESULTS: A total of five patients (4 women and 1 man) are described: two presented with a painless mass in the eyelid, two with a mass in the orbit, and one presented with a conjunctival lesion. All lesions were well demarcated with no capsule and were composed of blood vessels, a patternless spindle-shaped cell proliferation with a solid and pseudovascular appearance, and multinucleated giant cells. Both spindle-shaped and giant tumor cells were intensely positive for CD34 and vimentin. CONCLUSION: Giant cell angiofibroma resembles solitary fibrous tumor and giant cell fibroblastoma and should be considered in the differential diagnosis of spindle-cell tumors in the eyelid, orbit, and conjunctiva.

Trichoadenoma of the eyelid.

PURPOSE: To report the unique occurrence of a trichoadenoma of the eyelid. METHODS: An 80-year-old woman underwent surgical resection of a lesion of the right lower eyelid that was suspected to be a basal cell carcinoma. The lesion was studied with light microscopy. RESULTS: Histopathology showed a lesion in the dermis that contained keratin cysts surrounded by a proliferation of eosinophilic epidermoid cells. The findings were characteristic of a trichoadenoma. CONCLUSION: Trichoadenoma, a rare, benign, cutaneous tumor that usually occurs on the face, can develop on the eyelid and simulate a basal cell carcinoma.

Myolipoma of the eyelid.

BACKGROUND: This report describes the pathology of a myolipoma which occurred in the eyelid. Myolipoma is a benign hamartomatous tumour in which smooth muscle cells are interspersed with adipocytes. PATIENT DETAILS: An irregular yellowish tumour (30 x 25 mm) with illdefined borders had been present for 50 years in the medial part of the left lower eyelid of a 67-year-old woman. The tumour was excised and studied by conventional histology, immunohistochemistry and transmission electron microscopy. RESULTS: The tumour was formed by bundles of spindle-shaped cells with cigarshaped nuclei intermingled with multiloculated clear cells containing small eccentric nuclei. By immunohistochemistry, positive staining of the spindle cells was restricted to smooth muscle actin and desmin; the clear cells were non-reactive with the immunohistochemical panel, but fat was identified within the cytoplasm. The ultrastructural features of the spindle cells were those of a leiomyoma, while the clear cells were classified as adipocytes. CONCLUSION: This tumour was considered to originate from the media of blood vessels within the tumour.

[Glycohistochemical analysis of apoptotic bodies in eyelid tumor].

To clarify the relation between the mechanism of apoptosis in tumor tissues and sialic acids on the termini of sugar chains of glycoconjugates, a case of squamous cell carcinoma was examined using immunohistochemistry and glycohistochemistry. Immunohistochemistry and in situ hybridization histochemistry suggested that sialylation by the sialyltransferase in dominant in tumor cells, whereas hydrolysis of sialic acids by the sialidase is dominant in apoptotic bodies. Lectin histochemistry revealed that sialic acid alpha 2, 3 galactose beta 1, 3 N-acetylgalactosamine (Gal beta 1, 3 GalNAc) is present on the surfaces of tumor cells, and Gal beta 1, 3 GalNAc is present on those of apoptotic bodies. The exposed Gal beta 1, 3 GalNAc owing to the decrease in sialic acids on the surfaces of apoptotic bodies may be recognized by the C-type lectin on the macrophage for phagocytosis.

Apocrine gland tumor of the eyelid in a dog.

A 13-year-old male Shetland Sheepdog with progressive exophthalmos had a neoplastic mass in the ocular adnexa. Histologically, this neoplasm was composed of duct-forming epithelial cells with decapitation secretion. Tumor cells invaded the globe through the tunica conjunctiva and replaced the vitreous body. The cornea, iris, ciliary body, and retina were extensively destroyed. Both the epithelial and spindle-shaped myoepithelial cells showed nuclear atypia and mitotic activity in the globe. The primary tumor was diagnosed as adenocarcinoma, probably originating from apocrine sweat glands of the eyelid, and the infiltrating intraocular neoplasm was diagnosed as a malignant mixed tumor.

Lymphosarcoma with plasmacytoid differentiation in a scarlet macaw (Ara macao).

A lymphosarcoma in a scarlet macaw (Ara macao) affecting periocular structures is described. Microscopically and ultrastructurally, many of the lymphoid cells had plasmacytoid features. Polymerase chain reaction amplification failed to detect exogenous avian retrovirus RAV-1 in the neoplastic mass.

Brief communication, Histopathology of a spontaneously developing mast cell sarcoma in a Wistar rat.

A case report is given of a very rare spontaneous mast cell tumor in the eyelid of the left eye of a female Wistar rat used in a long-term oral toxicity study. Metastasis of the tumor had occurred in the mandibular lymph nodes and in the liver. Clinically, the animal showed blepharospasm, dacryorrhoea, and exophthalmus. Hematologic findings included slight eosinophilia and a remarkable basophilia. At necropsy, a bilateral conjunctivitis was diagnosed and a tumorous mass was found in the left submandibular region. Histologically, the tumor was composed of round to polygonal cells with pale cytoplasm, containing abundant predominantly basophilic granules. The intracytoplasmatic granules stained metachromatically with Toluidine blue and immunostained positively with serotonin. Numerous eosinophils were scattered throughout the tumor and were also present in other organs. Cells with round, oval, or indented nuclei and abundant cytoplasm, containing pronounced eosinophilic granules, were found in spleen and bone marrow. They turned out to be immature stages of eosinophilic granulocytes. Characteristics of the present tumor are compared with observations on mast cell tumors in other species.

Merkel cell carcinoma of the eyelid.

The Merkel cell is part of the dendritic cell population of the epidermis, and studies suggest it has a role as a slowly adapting mechanoreceptor involved with mediating the sense of touch. Merkel cells can give rise to malignant neoplasms, one tenth of which occur in the eyelid and periocular area, and manifest as painless erythematous nodules, with overlying telangiectatic blood vessels. Merkel cell carcinoma can mimic other malignant lesions, and the diagnosis can be difficult. One third of the tumors recur, and there is a high rate of metastasis. The estimated 5-year survival rate is 38%. Initial treatment should be aggressive, including surgical resection, with consideration of postoperative radiation. Merkel cell carcinoma responds to chemotherapy, but routinely recurs on cessation of treatment. Two cases are presented to illustrate the typical presentation of Merkel cell carcinoma and the importance of electron microscopy and immunohistochemical studies.

Phakomatous choristoma of the eyelid. Immunohistochemical and electron microscopic observations.

BACKGROUND: A 13-month-old Hispanic boy underwent excision of a congenital inferonasal orbital mass arising from the right lower lid. Results of histopathologic examination of the tumor showed a phakomatous choristoma of the eyelid. An immunohistochemical and electron microscopic study of this rare, benign, congenital tumor of lenticular anlage was performed. METHODS: Immunohistochemistry was performed on 4-microns thick sections from paraffin-embedded tissue. Electron microscopy was performed on thin sections stained with uranyl acetate and lead citrate. FINDINGS: The cuboidal epithelial cells that comprise this choristoma showed strongly positive cytoplasmic staining with S-100 protein and vimentin and focally positive staining with a keratin cocktail (AE1/AE3). Electron microscopy showed the presence of numerous 10-nm whorled cytoplasmic microfilaments within degenerating epithelial cells. CONCLUSION: The immunoreactivity of this tumor to keratin and vimentin are newly described in this detailed clinicopathologic report and, together with its S-100 positivity, support the proposal that this tumor is of lenticular anlage. The authors hypothesize that the intracytoplasmic 10-nm intermediate filaments observed with electron microscopic examination within the epithelial cells that comprise this choristoma represent vimentin as detected by immunohistochemistry.

[Orbital invasiveness of Merkel cell tumor of the eyelid]. / Envahissement orbitaire d'une tumeur à cellules de Merkel palpébrale.

A new case of neuroendocrine carcinoma (Merkel cell tumor) of the eyelid is reported. Local recurrence, spread to the orbit, led to exenteration and death of the patient. This trabecular carcinoma can be identified by histology, immuno-histochemistry and electron structural microscopy.

Gastric adenocarcinoma presenting as an eyelid and conjunctival mass.

A 50-year-old white man complained of "inflammation" of his right eyelid since January 1989. In June 1990, he had undergone a gastrectomy for an adenocarcinoma of the stomach. In August 1990, his right eye showed a painless, firm infiltration of the upper and lower lid, ulceration and loss of eyelashes of the upper lid and a reddish, subepithelial thickening of the medial bulbar conjunctiva. Biopsies of the right upper lid and nasal bulbar conjunctiva disclosed a metastatic, poorly differentiated adenocarcinoma of the stomach (signet ring cell carcinoma) both in the lid and conjunctival biopsies. Carcinoembryonic antigen (CEA) was detected in the tumor cells. Electron microscopic examination revealed tumor cells with signs of secretory activity. Although metastases to the eyelids and conjunctiva are rare, they may precede the clinical manifestation of the primary tumor for months or even years. In patients with chronic, recalcitrant lesions of eyelids or conjunctiva, especially if accompanied by loss of eyelashes, a primary or secondary malignancy should be excluded by early biopsies and histopathological examination.

Eccrine acrospiroma (clear cell hidradenoma) of the eyelid. Immunohistochemical and ultrastructural features.

A 46-year-old man underwent excision of a left lower eyelid mass that had enlarged over a 2-month period. Pathologic examination showed the mass to be an eccrine acrospiroma, a benign adnexal tumor that rarely arises in the eyelid. Light microscopic and ultrastructural examination showed two types of cells to comprise the tumor: eosinophilic cells with intracytoplasmic tonofilaments, and clear cells with intracytoplasmic glycogen granules. Immunohistochemical stains were positive for cytokeratins AE 1,3, epithelial membrane antigen, carcinoembryonic antigen, and muscle specific actin in tumor cells.

Primary extraskeletal mesenchymal chondrosarcoma of the lid.

A 15-year-old girl presented with a painless nodule in the nasal lower-lid portion of the left eye at the beginning of 1989. The tumor was excised in March 1989, and the histopathologic diagnosis was - erroneously - a chondromatous choristoma of the lid. The tumor recurred within several weeks. Another excision was performed, which led to the diagnosis of a malignant mesenchymal chondrosarcoma of the lid. Histopathology revealed the typical bimorphic pattern, with well-differentiated chondrocytes being surrounded by small anaplastic cells. The tumor cells stained positive for S100-protein and vimentin, were negative for cytokeratin and were studied ultrastructurally. Radical excision and adjuvant chemotherapy were performed in our patient; at 18 months after the onset of tumor growth, she is free of local or general tumor recurrence. To our knowledge, primary mesenchymal chondrosarcoma has not previously been described in the lid area.