bromochloroacetic-acid and Eyelid-Neoplasms

Sweat gland neoplasms are rare adnexal tumors that pose a diagnostic challenge for both, ophthalmologists and pathologists. Endocrine, mucin producing sweat gland carcinoma (EMPSGC), considered to be analogous to the solid papillary mammary carcinoma is one such tumor. It usually affects elderly, is more frequent in women and has a predilection for skin of the eyelid. Although it has an indolent clinical course, EMPSGC is believed to be a precursor of the invasive mucinous carcinoma and has a potential for local recurrence. We report a series of 10 biopsy-proven EMPSGCs with their immunohistochemical features and review the literature.

Topics: Adenocarcinoma, Mucinous; Aged; Aged, 80 and over; Biomarkers, Tumor; Biopsy; Eyelid Neoplasms; Female; Humans; Immunoenzyme Techniques; Keratins; Male; Membrane Transport Proteins; Middle Aged; Mucin-1; Mucins; Receptors, Estrogen; Receptors, Progesterone; Sweat Gland Neoplasms

Primary mucinous adenocarcinoma (PMA) of the eyelid is an exceptionally rare clinical entity. Often, it mimics with benign lesions on clinical examination and with metastatic mucinous adenocarcinoma on histological examinations. We report a case of PMA in a 60-year- old male patient who came with a slow-growing, painless swelling near the lower lid of the left eye. Excisional biopsy from the mass revealed a mucinous adenocarcinoma. To differentiate it from a metastatic mucinous adenocarcinoma, a wide range of immunohistochemistry panel was run. The tumor cells showed strong positivity for cytokeratin7, cytokeratin5/6, P63, estrogen receptor, progesterone receptor and negativity for cytokeratin20. Moreover, extensive metastatic work-up did not show any primary malignancy elsewhere, hence a final diagnosis of PMA was made. We believe that, this is the second reported case from the Middle East and the first in the Madinah region of Saudi Arabia.

Topics: Adenocarcinoma, Mucinous; Biopsy; Diagnosis, Differential; Eyelid Neoplasms; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Protein Isoforms; Receptors, Estrogen; Receptors, Progesterone

Topics: Actins; Adult; Eyelid Neoplasms; Female; Humans; Immunohistochemistry; Keratins; Leiomyosarcoma; Vimentin

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.. 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.. 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.. 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.

Topics: Choristoma; Eyelid Neoplasms; Humans; Immunoenzyme Techniques; Infant; Keratins; Lens, Crystalline; Male; Microscopy, Electron; S100 Proteins; Vimentin

This study examined immunohistochemical findings of sebaceous carcinoma and sebaceoma. An immunohistochemical study using 13 anti-cytokeratin (CK) antibodies (anti-CK1, 5-8, 10 and 14-20) and 35 cases of sebaceous carcinoma (16 cases on ocular and 19 cases on extraocular regions) and 10 cases of sebaceoma (no cases arose on the eyelids) was performed. Overall, those in ocular lesions were almost the same as those for extraocular lesions in sebaceous carcinoma other than CK8. The findings in sebaceous carcinoma were almost equal to those of sebaceoma. Over 75% of cases with sebaceous carcinoma were positive with anti-CK5 and anti-CK14 antibodies and negative with anti-CK1, CK10, CK15, CK17, CK18 and CK20 antibodies. Most cases (50-75%) of those were positive with CK7 and negative with CK6, CK16, CK19 and CK8. The sensitivity and specificity of immunohistochemical detection of sebaceous carcinoma using the panel of anti-cytokeratin antibodies were lower than those of other antibodies. Immunohistochemical detection of cytokeratins in diagnosing sebaceous carcinoma should be considered to be ancillary to conventional microscopic findings and those of other antibodies.

Topics: Adenocarcinoma, Sebaceous; Antibodies, Monoclonal; Carcinoma, Basal Cell; Diagnosis, Differential; Eyelid Neoplasms; Humans; Immunohistochemistry; Keratins; Sebaceous Gland Neoplasms

We report the clinical and histopathological characteristics of two cases of signet ring cell carcinoma of the eye lids, and discuss the histogenesis of this neoplasm. Two 72-year-old Caucasian males both presented with slowly growing tumours of the eyelids. The tumours were excised and specimens were examined using light- and transmission electron microscopic techniques. Clinically, the tumours infiltrated both eyelids on one side of the face with swelling and periocular inflammation, creating a monocle-like appearance. Extensive clinical work-up excluded periocular metastases. Histopathologically, the tumours were composed of rather bland cells with mainly histiocytoid morphology. A minor proportion had a signet ring cell appearance. The cytoplasmic inclusions giving the signet ring morphology were PAS- and colloidal iron positive. The tumour cells reacted with antibodies against cytokeratins, carcinoembryonic antigen, epithelial membrane antigen, gross cystic disease fluid protein-15 and lysozyme. Transmission electron microscopy demonstrated tumour cells containing intracytoplasmic vacuoles lined by microvilli. The tumour cells aggregated in duct-like clusters. A diagnosis of primary signet ring cell carcinoma was made in both cases. Histopathological, immunohistological and ultrastructural findings indicated that the tumours were of sweat gland origin.

Topics: Aged; Aminosalicylic Acid; Carcinoembryonic Antigen; Carcinoma, Signet Ring Cell; Carrier Proteins; Eyelid Neoplasms; Glycoproteins; Histocytochemistry; Humans; Immunohistochemistry; Intranuclear Inclusion Bodies; Iron Compounds; Keratins; Male; Membrane Transport Proteins; Microvilli; Mucin-1; Muramidase; Sweat Gland Neoplasms

A 93-year-old woman developed a mass on her right lower eyelid that was present for more than 6 months but underwent rapid expansion during several weeks prior to her ophthalmological evaluation. Examination revealed an approximately 1.8 cm in diameter, fleshy, fungating growth involving more than 60% of the right lower eyelid. Excisional biopsy disclosed a neoplasm arising from the epidermis composed of adjoining basal cell and signet-ring squamous cell carcinoma, without a transition zone. The cells comprising the basal and squamous cell carcinomas were distinct immunophenotypically, with only the basal cell carcinoma reacting with Ber-EP4 and CAM 5.2 antibodies. To our knowledge, this case represents the first example of a collision tumor composed of basal cell and signet-ring squamous cell carcinoma.

Topics: Aged, 80 and over; Biomarkers; Biomarkers, Tumor; Carcinoma, Basal Cell; Carcinoma, Signet Ring Cell; Carcinoma, Squamous Cell; Eyelid Neoplasms; Female; Humans; Keratins; Neoplasms, Multiple Primary; Treatment Outcome

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.

Topics: Carcinoma, Signet Ring Cell; Eccrine Glands; Eyelid Neoplasms; Female; Humans; Keratins; Microvilli; Middle Aged; Receptors, Estrogen

Topics: Adenocarcinoma; Biopsy; Breast Neoplasms; Carcinoembryonic Antigen; Eyelid Neoplasms; Fatal Outcome; Female; Humans; Keratins; Middle Aged; Mucin-1; Skin Neoplasms

Metastases to the eyelids are rare. They may appear as diffuse swellings, nodules or ulcerations. Most often they correspond to the dissemination of a breast adenocarcinoma. An 83 year old woman is reported with mammary adenocarcinoma metastasizing to the eyelids.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Apolipoproteins; Apolipoproteins D; Biomarkers; Breast Neoplasms; Carcinoembryonic Antigen; Carrier Proteins; Eyelid Neoplasms; Female; Glycoproteins; Humans; Immunohistochemistry; Keratins; Membrane Transport Proteins; Mucin-1

Diagnosis of sebaceous carcinoma of the periorbital region is often delayed. Clinically, this lesion can mimic several inflammatory disorders. Histopathologically, it can mimic either squamous cell or basal cell carcinoma.. To identify an immunohistochemical approach to assist in the diagnosis of periorbital sebaceous carcinoma.. The immunohistochemical profiles of several cases of periorbital sebaceous, basal cell, and squamous cell carcinoma were examined.. Although at least focal epithelial membrane antigen (EMA) staining can effectively distinguish sebaceous carcinoma (10 of 11 were positive) from basal cell carcinoma (1 of 16 were positive), most squamous cell carcinomas examined were also focally EMA positive (11 of 14). However, Cam 5.2 reactivity was seen in most sebaceous carcinomas (8 of 11) but no squamous cell carcinomas (0 of 14). In addition, at least focal BRST-1 reactivity was also seen in most sebaceous carcinomas (7 of 11) but no basal cell carcinomas (0 of 16).. Periorbital sebaceous, basal cell, and squamous cell carcinomas have different immunohistochemical staining profiles; a panel of commonly available antibodies, including anti-EMA, BRST-1, and Cam 5.2, may help distinguish these diseases from each other when that distinction cannot be clearly made by light microscopy alone.

Topics: Adenocarcinoma, Sebaceous; Adult; Aged; Aged, 80 and over; Antigens, Neoplasm; Biomarkers, Tumor; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Conjunctival Neoplasms; Diagnosis, Differential; Eyelid Neoplasms; Female; Glycoproteins; Humans; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Mucin-1

Merkel cell carcinomas (MCC) not infrequently involve the periorbital region and the eyelids. Clinically, they are relatively characteristic but often unsuspected. Histologically, MCC are often misdiagnosed as lymphoma, melanoma, or metastatic small cell carcinoma of the lung (SCCL).. We present clinical, histological, and immunohistochemical data on six eyelid cases (all females; age 63-102 years; one with concomitant CLL) from our files of 77 MCC with special respect to differential diagnosis. For comparison, 22 SCCL were analyzed. Immunohistochemistry was done with antibodies against pan-cytokeratin (pan-CK), cytokeratin-20 (CK-20), neurofilament protein (NF), neuron-specific enolase (NSE), chromogranin (CHR), and S100 protein (S100).. Morphologically, five of six MCC were prototypic, one was of the small cell variant. Immunohistochemically, dot-like positivities for pan-CK and CK-20 were seen in all six MCC, and for NF in five tumors. None of the 22 SCCL stained positively for CK-20 or NF but 21/22 cases were positive for pan-CK. Only 1/21 SCCL showed dot-like patterns for pan-CK; 20/21 reacted diffusely. All MCC and 13/22 SCCL displayed CHR-positive cells. All MCC and all SCCL were positive for NSE and negative for S100.. Dot-like positivities for CK-20 or NF are important to prove MCC and to exclude SCCL in clinically and morphologically doubtful cases. Dot-like positivities for pan-CK favor MCC, but do not always exclude SCCL. NSE and CHR are of no value for the differential diagnosis of MCC and SCCL. Melanoma and lymphoma are ruled out by negativity for S100 and pan-CK, respectively.

Topics: Aged; Aged, 80 and over; Carcinoma, Merkel Cell; Carcinoma, Small Cell; Diagnosis, Differential; Eyelid Neoplasms; Female; Humans; Immunoenzyme Techniques; Keratins; Leukemia, Lymphocytic, Chronic, B-Cell; Lung Neoplasms; Middle Aged; Neurofilament Proteins; Phosphopyruvate Hydratase; S100 Proteins

Sclerosing sweat-duct carcinoma or malignant syringoma is a rare eyelid tumor. The authors report the first patient with sclerosing sweat-duct carcinoma involving the upper eyelid and present its immunohistochemical and ultrastructural features. The clinical features and the histopathologic and ultrastructural findings that distinguish this tumor from its benign counterparts are discussed. Sclerosing sweat-duct carcinomas are slow growing but locally invasive neoplasms that have a propensity to recur. Wide and deep surgical excision with frozen section evaluation of margins is recommended.

Topics: Biomarkers, Tumor; Biopsy; Carcinoembryonic Antigen; Eyelid Neoplasms; Eyelids; Humans; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Mucin-1; Sweat Gland Neoplasms; Sweat Glands; Syringoma

Topics: Animals; Brain Neoplasms; Carcinoma, Squamous Cell; Cattle; Cattle Diseases; Diagnosis, Differential; Euthanasia; Eyelid Neoplasms; Female; Horner Syndrome; Keratins; Pituitary Gland; Pituitary Neoplasms; Vimentin

Topics: Adrenal Gland Neoplasms; Eyelashes; Eyelid Neoplasms; Female; Follow-Up Studies; Hidrocystoma; Humans; Keratins; Middle Aged; Mucin-1; Neoplasms, Multiple Primary; Prolactinoma; Sweat Gland Neoplasms

The type and distribution of keratins (K) in malignant tumors of eyelids were examined immunohistochemically to understand the pathomechanism of intercellular interactions. All of the tumor cells in the basal cell carcinoma were positive for K14, which is specific for basal cells, whereas all of them were negative for K10, which is specific for suprabasal layers in stratified squamous epithelia. These findings suggest that basal cell carcinoma may consist of uniform, basal cell-like tumor cells. On the other hand, the squamous cell carcinoma and sebaceous carcinoma, which were positive for either K14 or K10 to varying extent, may consist of various tumor cells with different types and degrees of differentiation. In these tumors, K14 was frequently detected throughout the border cells of the tumor mass. Apoptotic bodies were detected at the region where this continuous distribution of K14 was interrupted. These findings may help to clarify the pathomechanism of the interactions between the tumor cells and stromal cells.

Topics: Adenocarcinoma, Sebaceous; Aged; Aged, 80 and over; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Eyelid Neoplasms; Female; Humans; Immunohistochemistry; Keratins; Male; Middle Aged

The distributional patterns of MUC 1 (the mucin whose cDNA was first cloned) and Keratin 14 (K14) in the invasive regions of malignant eyelid tumors were immunohistochemically examined by comparing with other histochemical markers. The MUC 1-positive tumor cells were detected in several serial, small, invasive tumor masses in the deep subepithelial region of the low differentiated carcinoma. They were also continuously detected in the border region between accumulated lymphocytes including T cells and tumor masses of the sebaceous carcinoma. On the other hand, K14-positive tumor cells were detected in the marginal regions of large tumor masses or those with smooth edges, some of which overlapped the distribution of MUC 1-positive cells in the tissues of undifferentiated carcinoma, squamous cell carcinoma, and sebaceous carcinoma. In general, MUC 1 may be expressed in the invasive tumor cells, whereas K14 may be expressed in the marginal cells of the stable, proliferating tumor masses.

Topics: Adenocarcinoma, Sebaceous; Aged; Aged, 80 and over; Carcinoma; Carcinoma, Squamous Cell; Eyelid Neoplasms; Female; Humans; Immunohistochemistry; Keratin-14; Keratins; Male; Middle Aged; Mucin-1; Mucins; Neoplasm Invasiveness

Mucinous carcinoma is a rare primary eyelid malignancy. It is, however, more common in other sites and may metastasize to the eye. Thus, it is important to consider a distant primary when diagnosing mucinous carcinoma of the eyelid. We studied various immunohistochemical markers that may be useful. Two cases of mucinous carcinoma from the eyelid were reacted with antibodies to cytokeratins (35-beta-H11), carcinoembryonic antigen, S-100 protein, gross cystic disease fluid protein-15, alpha-lactalbumin, estrogen receptor, and progesterone receptor. All antigens were positive in both cases. This study shows that immunohistochemistry may help exclude metastatic mucinous carcinoma to the eyelid from many sites, except the breast, which the eyelid primary closely resembles. Thus, a breast primary should be specifically sought and excluded clinically.

Topics: Adenocarcinoma, Mucinous; Aged; Apolipoproteins; Apolipoproteins D; Biomarkers, Tumor; Carcinoembryonic Antigen; Carrier Proteins; Eyelid Neoplasms; Female; Glycoproteins; Humans; Immunohistochemistry; Keratins; Lactalbumin; Male; Membrane Transport Proteins; Middle Aged; Neoplasm Proteins; Receptors, Estrogen; Receptors, Progesterone; S100 Proteins; Skin Neoplasms

Phakomatous choristoma is a rare, congenital, ocular adnexal tumor that is presumed to be of lenticular anlage based on light and electron microscopy.. The authors performed immunohistochemistry using standard commercially available antibodies against vimentin, S-100 protein, and several cytokeratins on a phakomatous choristoma that was excised from the right lower eyelid of a 10-week-old white boy. In addition, a battery of antibodies against lens-specific proteins, including alpha, beta, and gamma crystallins, was used.. The tumor cells showed intense immunoreactivity for all lens-specific proteins tested. The epithelial cells of the phakomatous choristoma stained positively for S-100 protein and vimentin, the intermediate filament normally found in lens epithelial cells. Keratin markers were negative.. The results of immunohistochemistry indicate that the cells of phakomatous choristoma synthesize several types of lens-specific proteins. Complementing previous light and electron microscopic studies, these data strongly support Zimmerman's conclusion that this pediatric adnexal tumor is a choristoma of lenticular anlage.

Topics: Antibodies, Monoclonal; Choristoma; Crystallins; Epithelium; Eyelid Neoplasms; Humans; Immunoenzyme Techniques; Infant; Keratins; Lens, Crystalline; Male; S100 Proteins; Tomography, X-Ray Computed; Vimentin

Merkel cell carcinoma of the eyelid is a rare malignant tumor. Immunohistochemical studies can be helpful in establishing the diagnosis of this tumor. We encountered a case of Merkel cell carcinoma of the eyelid and conducted an immunohistochemical analysis for clarification of its cell properties. The patient in this study was a 78-year-old man who noted a small mass on his right upper eyelid, which was subsequently removed. However, the lesion recurred and progressively enlarged. The results of a biopsy indicated the possibility of a highly malignant tumor. The lesion was removed by orbital exenteration. Merkel cell carcinoma was finally diagnosed by using light and electron microscopy. In immunohistochemical studies, the tumor cells showed both neuron-specific enolase and cytokeratin. Most of the cells were also labeled with antibodies against the protein gene product 9.5, endocrine granule constituent and chromogranin A. However, no neuropeptides were labeled. The properties of the tumor cells appeared virtually the same as those of normal human Merkel cells.

Topics: Aged; Carcinoma, Merkel Cell; Chromogranin A; Chromogranins; Eyelid Neoplasms; Humans; Immunoenzyme Techniques; Keratins; Male; Neuropeptides; Phosphopyruvate Hydratase; Thiolester Hydrolases; Ubiquitin Thiolesterase

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.

Topics: Actins; Adenoma, Sweat Gland; Eyelid Neoplasms; Humans; Immunoenzyme Techniques; Keratins; Male; Membrane Glycoproteins; Middle Aged; Mucin-1

Primary neuroendocrine carcinomas of the skin were recognized as distinctive neoplasms and clinicopathologic information on their location on the eyelids have been reported. The authors present one case of primary neuroendocrine carcinoma occurring on the right lower lid in a 73-year-old woman. The clinical history, light and electron microscopic findings as well the results of an immunohistochemical study are described. The ultrastructural study demonstrated the characteristic membrane-bound dense-core neurosecretory granules. Immunoreactivity for neuron-specific enolase, keratin filaments, epithelial membrane antigen and calcitonin were observed and are strongly suggestive of a neuroendocrine differentiation in a neoplasm of epithelial origin. Various hypothesis concerning the origin of this tumor are discussed on the basis of the immunohistochemical findings. The authors also provide a brief review of the literature.

Topics: Aged; Antibodies, Monoclonal; Calcitonin; Carcinoma, Merkel Cell; Eyelid Neoplasms; Female; Humans; Immunoenzyme Techniques; Keratins; Membrane Glycoproteins; Mucin-1; Phosphopyruvate Hydratase

Case report of a rare eyelid tumor in an 83-year-old woman. The excised lesion was classified as a neuroendocrine Merkel cell carcinoma on the basis of histologic, ultrastructural, and immunohistochemical examination. Detection of neurosecretory granules by electron microscopy and the characteristic cytokeratin and neurofilament pattern supported the diagnosis. The patient developed a local recurrence, which was successfully removed. There is no evidence of regional or distant metastases.

Topics: Aged; Aged, 80 and over; Eyelid Neoplasms; Eyelids; Female; Fluorescent Antibody Technique; Humans; Keratins; Microscopy, Electron

An infrared spectrum of the calcified epithelioma excised from the eyelid of a three-year old girl was observed. Main absorption peaks were assigned as proteins and calcium phosphate. The crystallinity of calcium phosphate was 41%. The relative content of proteins and calcium phosphate was monitored as 7.4:1, reproducing the spectrum of the calcified epithelioma with a mixture of keratin and calcium phosphate. An epithelioma taken from the trunk of a 41-year-old man showed no calcification and the infrared spectrum of this epithelioma showed no absorption peaks of calcium phosphate.

Topics: Adult; Calcinosis; Calcium Phosphates; Carcinoma; Child, Preschool; Eyelid Neoplasms; Female; Humans; Keratins; Male; Neoplasm Proteins; Skin Neoplasms; Spectrophotometry, Infrared

Keratinization of the tarsal conjunctiva in an eye with adequate tears occurs following a number of conditions, including irritation and sensitivity to topical medications, Stevens-Johnson syndrome, radiation to the lid, and occasionally from unknown causes. The keratinized cells produce an epithelial keratitis with subsequent vascularization of the cornea. The morphogenesis of this condition is discussed, along with therapy including mucous membrane grafts and freezing of the tissue.

Topics: Animals; Conjunctiva; Cornea; Epidermis; Eye Diseases; Eyelid Neoplasms; Humans; In Vitro Techniques; Keratins; Keratitis; Metaplasia; Stevens-Johnson Syndrome; Vitamin A Deficiency

Topics: Adolescent; Adult; Aged; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Eyelid Neoplasms; Eyelids; Female; Humans; Keratins; Male; Middle Aged; Neoplasm Recurrence, Local; Radiation Protection; Radiotherapy; Tears; Telangiectasis

Topics: Adolescent; Adult; Aged; Basophils; Calcinosis; Child; Child, Preschool; Citrulline; Epithelial Cells; Eyelid Neoplasms; Facial Neoplasms; Female; Granulation Tissue; Hair; Humans; Infant; Keratins; Male; Sex Factors; Skin Neoplasms; Staining and Labeling; Syndrome