A Case of Metastatic Colonic Adenocarcinoma of the Eyelid

PURPOSE: To report a metastatic colonic adenocarcinoma in the left upper eyelid. CASE SUMMARY: A 73-year-old male presented to our clinic with a palpable mass in his left upper eyelid that had appeared 10 days prior. The patient had a history of colon cancer that was diagnosed 2 years previously with liver and lung metastases, and he had underwent colon resection followed by chemotherapy. A 10.7 x 14.7 x 9.0 mm mass was observed on orbital computed tomography and a biopsy confirmed that the mass was a metastatic colonic adenocarcinoma. Because radical resection of the mass could not be performed, a debulking surgery was performed instead. The patient was followed up while receiving conservative treatment, but he died 3 weeks after surgery. CONCLUSIONS: Metastatic tumors in the eyelids are very rare and colonic adenocarcinoma metastases in the eyelids are even less common. Thus, a biopsy examination and appropriate treatment should be administered to patients with a history of malignancy who present with an eyelid mass.

Expression of Cytokeratins 7 and 20 in Cholangiocarcinoma and Metastatic Colonic Adenocarcinoma of the Liver

The distinction between cholangiocarcinoma (CC) and metastatic colonic adenocarcinoma of the liver (MCA) is often difficult, particularly in needle biopsy and fine-needle aspiration specimens, if histologic features alone are used. To examine the differences in the expressions of the cytokeratin (CK) 7 and 20 in the CCs and MCAs, we performed immunohistochemical studies on surgically resected 19 CCs and 23 MCAs. We used monoclonal antibodies against CK 7 and CK 20, and applied microwave antigen retrieval technique on formalin-fixed, paraffin-embedded tissue. We interpreted diffuse cytoplasmic reactivity found in > or =5% of tumor cells as positive. CCs showed CK 7+/CK 20- immunophenotype in 63%, CK 7+/CK 20+ in 32%, CK 7-/CK 20+ in 5%, and CK 7-/CK 20- in 0%. MCAs exhibited CK 7-/CK 20+ immunophenotype in 87%, CK 7+/CK 20+ in 9%, CK 7-/CK 20- in 4%, and CK 7+/CK 20- in 0%. CK 20-reactive cells in CCs were frequently columnar in shape (p<0.05). In conclusion, the CK 7/CK 20 immunophenotype was useful in the differentiation of CCs from MCAs: the CK 7+/CK 20- immunophenotype strongly suggested CCs, whereas the CK 7-/CK 20+ immunophenotype strongly suggested MCAs.