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Feng Y, Chiou CA, Wolkow N. Cystic-Appearing Eyelid Lesion in a 62-Year-Old Man. JAMA Ophthalmol 2024; 142:266-267. [PMID: 38329738 DOI: 10.1001/jamaophthalmol.2023.6637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
A 62-year-old male was referred for evaluation of a painless right lower-eyelid lesion noted during routine glaucoma follow-up. The lesion had been present for 3 years with slow, gradual enlargement. What would you do next?
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Affiliation(s)
- Yilin Feng
- Ophthalmic Plastic Surgery, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
| | - Carolina A Chiou
- Ophthalmic Plastic Surgery, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
| | - Natalie Wolkow
- Ophthalmic Plastic Surgery, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
- David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
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Freeman T, Russell AJ, Council ML. Primary Cutaneous Mucinous Carcinoma: A Review of the Literature. Dermatol Surg 2023; 49:1091-1095. [PMID: 37643246 DOI: 10.1097/dss.0000000000003921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Primary cutaneous mucinous carcinoma (PCMC) is an exceedingly rare, low-grade tumor that histologically resembles mucinous carcinoma from other primary sites, such as the breast, gastrointestinal tract, and lungs. OBJECTIVE The purpose of this article was to review the current literature on PCMC as it relates to epidemiology, clinical presentation, histopathology, immunohistochemistry, treatment, and prognosis. MATERIALS AND METHODS An extensive literature review was conducted using PubMed and Ovid MEDLINE to identify articles related to PCMC. RESULTS Several hundred cases have been reported in the medical literature, and surgical resection, whenever feasible, is the standard of care. CONCLUSION The diagnosis of primary cutaneous mucinous carcinoma is one of exclusion, requiring a metastatic work-up to rule out distant primary. Mohs micrographic surgery is a tissue sparing technique that allows complete margin control of these rare neoplasia.
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Affiliation(s)
- Timothy Freeman
- Washington University School of Medicine, St. Louis, Missouri
| | - Aaron J Russell
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - M Laurin Council
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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Park JM, Kim SS. A Case of Primary Mucinous Adenocarcinoma of the Lower Eyelid. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.2.176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jun Min Park
- Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea
| | - Sang Soo Kim
- Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea
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Tak MS, Cho SE, Kang SG, Kim CH, Kim DW. Primary Cutaneous Mucinous Carcinoma of the Eyelid. Arch Craniofac Surg 2017; 17:176-179. [PMID: 28913279 PMCID: PMC5556810 DOI: 10.7181/acfs.2016.17.3.176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 07/05/2016] [Accepted: 07/10/2016] [Indexed: 11/11/2022] Open
Abstract
Primary cutaneous mucinous carcinoma (PCMC) is a rare low-grade malignant neoplasm derived from the eccrine glands. PCMC most commonly arises in the head and neck, with the eyelid being the most common site of origin. This case report describes a 51-year-old male with a painless, pigmented superficial nodular lesion over his right lower eyelid. The lesion was considered to be benign, and the initial treatment was simple excision with a 3-mm margin. However, histologic examination revealed the diagnosis of PCMC, and the patient underwent re-excision of the tumor site with an additional 3-mm margin from the initial scar. Histologic study of this second margin was free of any malignant cells. The patient experienced no postoperative complication or recurrence after 2 years. In our case, the skin lesion had benign morphologic findings and was strongly suspected to be a benign mass. Physicians should be aware of this tumor and be able to differentiate it from benign cystic or solid eyelid lesions.
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Affiliation(s)
- Min Sung Tak
- Department of Plastic and Reconstructive Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seong Eun Cho
- Department of Plastic and Reconstructive Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Sang Gue Kang
- Department of Plastic and Reconstructive Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Chul Han Kim
- Department of Plastic and Reconstructive Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Dong Won Kim
- Department of Pathology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Souaf I, Ameurtesse H, Debbagh FZ, Idrissi K, Znati K, Amarti A. [Mucinous primitive skin carcinoma: report of two cases and review of the literature]. Pan Afr Med J 2015; 18:340. [PMID: 25574316 PMCID: PMC4282812 DOI: 10.11604/pamj.2014.18.340.2970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 08/26/2014] [Indexed: 11/11/2022] Open
Abstract
Le carcinome mucineux primitif cutané est une tumeur annexielle rare, développée à partir des glandes sudoripares. Il se localise en générale à l'extrémité céphalique, surtout la région périorbitaire. Nous rapportons deux observations d'un carcinome mucineux primitif de la face et de la région axillaire, chez deux patients âgés de 60 ans. L’étude histologique montrait une prolifération tumorale dermohypodermique, faite de cellules organisées en cordons, en amas et en massif cribriformes, au sein d'une substance mucoïde. En immunohistochimie les cellules tumorales exprimaient la cytokératine 7, l'EMA et les récepteurs hormonaux. L'actine musculaire lisse a bien marqué les cellules myoépithéliales au niveau de la composante in situ dans un seul cas. Le carcinome mucineux primitif cutané est difficile à différencier d'une métastase mammaire ou digestive. La mise en évidence de carcinome in situ ou de cellules myoépithéliale est en faveur de l'origine cutanée primitive. C'est une tumeur à croissance lente, avec des métastases exceptionnelles. Le traitement est chirurgical et le taux de récidive est très élevé. Et à travers ces deux observations, les auteurs mettent en relief les principaux aspects cliniques, histologiques, thérapeutiques de cette entité avec une revue de la littérature.
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Affiliation(s)
- Ihsane Souaf
- Service d'Anatomie et de Cytologie Pathologique, CHU Hassan II, Fès, Maroc
| | | | | | - Karima Idrissi
- Service d'Anatomie et de Cytologie Pathologique, CHU Hassan II, Fès, Maroc
| | - Kawter Znati
- Service d'Anatomie et de Cytologie Pathologique, CHU Hassan II, Fès, Maroc ; Laboratoire de Recherche et Biologie de cancer, CHU Hassan II, Fès, Maroc
| | - Affaf Amarti
- Service d'Anatomie et de Cytologie Pathologique, CHU Hassan II, Fès, Maroc ; Laboratoire de Recherche et Biologie de cancer, CHU Hassan II, Fès, Maroc
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Mucinous eccrine carcinoma: a rare case of recurrence with lacrimal gland extension. Ophthalmic Plast Reconstr Surg 2012; 28:e109-10. [PMID: 22327636 DOI: 10.1097/iop.0b013e31823c80ba] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mucinous eccrine carcinoma (MEC) is a rare skin cancer of sweat gland origin with a high rate of recurrence. The most common sites are head and neck, with 40% of cancers found on the eyelid. The clinical appearance and differential diagnosis of MEC are highly varied, but histologically it is similar to metastatic carcinomas, specifically breast and colon. A diagnosis of primary MEC always warrants a full systemic workup to ensure that no other malignancy is present. This cancer is known for frequent recurrences, but rarely metastasizes to distant organs. MEC is resistant to both chemotherapy and radiation; surgical excision remains the treatment of choice in most cases. The authors report a unique case of extension of MEC to the lacrimal gland with a brief review of histologic characteristics of this tumor.
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Sheth RN, Placantonakis DG, Gutin PH. Intracranial and spinal metastases from eccrine mucinous carcinoma: case report. Neurosurgery 2011; 67:E861-2. [PMID: 20657314 DOI: 10.1227/01.neu.0000377860.59894.a3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND IMPORTANCE Mucinous eccrine carcinoma (MEC) is a rare but distinct type of sweat gland tumor. MECs tend to recur locally, and their spread to distant organs is very uncommon. This article describes the first case of MEC metastasizing to the brain and the spine. CLINICAL PRESENTATION A 45-year-old female presented with a 2-year history of a scalp mass in the occipital area with lymph node spread. She underwent excision of the mass and neck lymph node dissection. Pathology confirmed the diagnosis of MEC. Postoperatively, she received radiation to the involved areas. Four years later the patient presented with left hemiparesis and underwent craniotomy for gross total resection of the metastasis. This recurred after 2.5 years and she underwent another craniotomy for gross total resection followed by whole brain radiation. In addition, the patient had metastases to T11 vertebral body and the left C6 to 7 neural foramen. Moreover, the patient developed leptomeningeal disease in the spine. The metastases to the spine were treated with radiation therapy. The patient died 1.5 years later. CONCLUSION Even though it is rare for MEC to spread to distant organs, physicians should be aware of the risk of metastatic invasion of the brain and spine and be vigilant about surveillance of these sites. MEC metastases to the brain should be treated aggressively with surgical resection followed by stereotactic radiosurgery to the tumor bed. Spine metastases should be treated with a combination of surgery and image-guided radiation therapy, depending on the degree of cord compression from epidural metastatic disease.
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Affiliation(s)
- Rishi N Sheth
- Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
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Segal A, Segal N, Gal A, Tumuluri K. Mucinous sweat gland adenocarcinoma of the eyelid - current knowledge of a rare tumor. Orbit 2010; 29:334-340. [PMID: 21158574 DOI: 10.3109/01676830.2010.516469] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE To review the medical literature on mucinous sweat gland adenocarcinoma of the eyelid (MSA) and present two new cases. METHODS Details of published case reports and small series (between 1971-2010) were evaluated and summarized including two patients diagnosed and treated at our institution. Data regarding age, gender, ethnicity, precise location, clinical presentation, treatment and follow up of each patient were collected. RESULTS 25 reports describing 55 patients were found in the medical literature. The mean age was 61.3 years (30-87), 22(59%) were male and 28(80%) were Caucasian. In 23(44.2%) patients the lesion was in the lower lid, in 20(38.5%) in the upper lid, in 3(5.7%) involving both lids and in 6(11.6%) in a canthus. In 12(21.8%) patients a lesion with a benign diagnosis was previously excised from the same location. In 2 of them histological re-examination resulted in a diagnosis of MSA. Intraorbital involvement was found in 2(3.6%) patients. Regional lymph node metastasis was found in 2(4.4%) patients. Surgical excision was the treatment of choice using Mohs' micrographic-controlled excision technique in recent years. Radiotherapy was applied to 2 patients with clinical resolution in 1. Recurrence of the tumor was reported in 14(30%) patients. CONCLUSIONS MSA is a rare tumor of the eyelid with no clinically distinguishing features. It should be suspected particularly with recurrent eyelid lesions and must be differentiated from metastatic disease. The tumor may extend into the orbit and metastasize regionally. Surgical removal with continued regular follow-up examination is the treatment of choice.
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Affiliation(s)
- Avichai Segal
- Oculoplastic Surgery Unit, Sydney Eye Hospital, Sydney, New South Wales, Australia.
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Chauhan A, Ganguly M, Takkar P, Dutta V. Primary mucinous carcinoma of eyelid: a rare clinical entity. Indian J Ophthalmol 2009; 57:150-2. [PMID: 19237793 PMCID: PMC2684428 DOI: 10.4103/0301-4738.45509] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Primary cutaneous mucinous carcinoma of the eyelid, a rare pathologic entity, is an adenocarcinoma of the eccrine glands. Though it has low metastatic potential, it does have a significant recurrence rate. We present the occurrence, clinical and histological features, and management of this tumor in a 62-year-old male who presented with a recurrent, firm, nodular left lower lid lesion. He underwent excision with a 5 mm margin and the defect was repaired with a Mustarde's cheek rotation flap. A full oncological screening, including whole-body Positron Emission Tomography scan, excluded the presence of primary mucinous carcinoma elsewhere and any metastatic spread. This case underscores the importance of considering this tumor in recalcitrant eyelid lesions and highlights the pathology of this tumor.
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Affiliation(s)
- Ashutosh Chauhan
- Department of Oncosurgery, Army Hospital (Research and Referral) , Delhi, India.
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MESH Headings
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/therapy
- Carcinoma, Signet Ring Cell/diagnosis
- Carcinoma, Signet Ring Cell/epidemiology
- Carcinoma, Signet Ring Cell/therapy
- Combined Modality Therapy/methods
- Diagnosis, Differential
- Eyelid Neoplasms/diagnosis
- Eyelid Neoplasms/epidemiology
- Eyelid Neoplasms/therapy
- Facial Neoplasms/diagnosis
- Facial Neoplasms/epidemiology
- Facial Neoplasms/therapy
- Humans
- Incidence
- Mycosis Fungoides/diagnosis
- Mycosis Fungoides/epidemiology
- Mycosis Fungoides/therapy
- Prognosis
- Sarcoma, Kaposi/diagnosis
- Sarcoma, Kaposi/epidemiology
- Sarcoma, Kaposi/therapy
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/therapy
- Sweat Gland Neoplasms/diagnosis
- Sweat Gland Neoplasms/epidemiology
- Sweat Gland Neoplasms/therapy
- Syringoma/diagnosis
- Syringoma/epidemiology
- Syringoma/therapy
- United States/epidemiology
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Affiliation(s)
- Jonathan W Kim
- Department of Ophthalmology, Stanford University Medical Center, Stanford, CA 94304, USA
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