ABSTRACT
PurposeMeibomian gland ductal cysts (MGDCs) and steatocystomas are epithelial lined, keratin-containing lesions of the eyelids. MDGCs are variably called tarsal keratinous cysts, intratarsal keratinous cysts of the meibomian glands, intratarsal inclusion cysts, epidermal cysts and epidermoid cysts. Both lesions are poorly described in the literature. We report a series of seven MGDC and steatocystomas, and examine their clinical, pathological and immunohistochemistry features and their management and outcomes.Patients and methodsA retrospective review of case notes and histopathology slides of all MGDCs and steatocystomas identified at one major histopathology service in South Australia between 2013 and 2015.ResultsSeven cases were identified, with an average age of 64. The lesions range from 4 to 18 mm diameter and are firm, well-circumscribed and non-tender, and sometimes the keratin-filled cyst protrudes visibly under the tarsal conjunctiva. Two cases were previously misdiagnosed as chalazia but recurred after incision and curettage. Histologically, these lesions are lined by squamous epithelium but lack a well-formed stratum granulosum and can be distinguished by their immunohistochemical staining characteristics. Complete excision, including a wedge of underlying tarsal plate for MDGCs, is curative for with a follow up of 12-36 months.ConclusionsMGDCs and steatocystomas should be included in the differential of benign eyelid lesions. Diagnosing and differentiating these lesions from chalazia is important for determining the optimal management strategy.
Subject(s)
Epidermal Cyst/diagnosis , Eyelid Diseases/diagnosis , Eyelids/pathology , Immunohistochemistry/methods , Keratins/metabolism , Meibomian Glands/pathology , Sebaceous Gland Diseases/diagnosis , Adult , Aged , Aged, 80 and over , Diagnosis, Differential , Epidermal Cyst/classification , Epidermal Cyst/metabolism , Eyelids/metabolism , Female , Follow-Up Studies , Humans , Male , Meibomian Glands/metabolism , Middle Aged , Retrospective Studies , Sebaceous Gland Diseases/classification , Sebaceous Gland Diseases/metabolismABSTRACT
Sebaceous neoplasms have long been a source of confusion to dermatologists and pathologists alike. Disagreements regarding nomenclature, classification, and management have been longstanding. Sebaceous lesions represent a broad spectrum of interesting entities that range from hamartomas, hyperplasias, and benign tumors to highly malignant neoplasms. This article discusses the clinical and pathologic features of sebaceous hyperplasia, nevus sebaceous of Jadassohn, sebaceous adenoma, seboacanthoma, sebaceous epithelioma, sebaceoma, mantleoma, basal cell carcinoma with sebaceous differentiation, sebomatricoma (sebomatrixoma), and sebaceous carcinoma. Controversies regarding these lesions will be explored, and any relationship with Muir-Torre syndrome will be discussed.
Subject(s)
Sebaceous Gland Diseases/classification , Sebaceous Gland Diseases/pathology , Sebaceous Gland Neoplasms/classification , Sebaceous Gland Neoplasms/pathology , Dermatology , Education, Medical, Continuing , HumansABSTRACT
The nomenclature for benign tumors with foci of sebaceous differentiation is confusing and varied. In this study, the defining histological features of six such cases are reported, all distinguished pathologically by a superficial proliferation of uniform basaloid cells containing mature sebocytes in varied proportions with attachments to the overlying epidermis. Furthermore, the unifying architecture of the cases presented supports maintenance of the original nomenclature of superficial epithelioma with sebaceous differentiation and indicates that this neoplasm is perhaps not as rare as currently believed.
Subject(s)
Hamartoma/classification , Hamartoma/pathology , Sebaceous Gland Diseases/classification , Sebaceous Gland Diseases/pathology , Aged , Diagnosis, Differential , Humans , Keratosis, Seborrheic/pathology , Male , Middle AgedABSTRACT
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