A Case of Apocrine Adenocarcinoma of the Upper Eyelid

PURPOSE: To report a case involving an eyelid mass that was diagnosed as apocrine carcinoma. CASE SUMMARY: A 52-year-old man visited our hospital with a recurrent mass on his right upper eyelid, which had developed 4 years prior. Initially, he received laser therapy at a dermatologic clinic to remove the mass. Two years later, the mass recurred and was excised at another clinic. At the time the patient visited our institution, the lesion had developed into multiple erythematous nodules at the margin of the right upper eyelid. The results of excisional biopsy performed under local anesthesia revealed hidradenoma papilliferum. One month after excision, recurred multiple elevated nodules were found at the margin of the excision, and thus total excision of the mass and reconstruction of the upper eyelid was performed. Biopsy confirmed that the mass was apocrine adenocarcinoma. Five months have passed since the excision and no evidence of recurrence has been observed. CONCLUSIONS: Apocrine adenocarcinoma is a malignant tumor of the sweat gland and is rarely found on the eyelid. Apocrine adenocarcinoma should be considered in the differential diagnosis of recurrent eyelid mass at the eyelid margin.

A Report of Localized Corneal Amyloidosis Secondary to the Trichiasis

PURPOSE: To report our experience in the diagnosis and treatment of a localized corneal amyloidosis secondary to trichiasis. METHODS: Case 1. A 55-year-old woman visited our clinic due to discomfort of her right eye. Thirty years previously, she received a lower lid blepharoplasty due to lower lid entropion. Biomicroscopy revealed some trichiasis and a 3 mm, grayish-white nodule at the center of the cornea. Case 2. A 30-year-old woman visited our clinic due to chronic irritation of both eyes. Ten and 3 years previously, she received a lower lid blepharoplasty. Biomicroscopy revealed some trichiasis of the right lower lid and a grayish-white, patch-like lesion at the inferior cornea of both eyes. Lamellar keratectomy and amniotic membrane transplantation with careful electrolysis were performed. RESULTS: Hematoxylin and eosin stain revealed a pink, amorphous, hyaline material under the epithelium, and Congo-red stain showed birefringence of the whitish lesion. Electron microscopy revealed multidirectional, fibrillar arrangement. Secondary, localized amyloidosis of the cornea was diagnosed without any systemic involvement. No clues to the origin of the amyloid were found by immunohistochemical staining. By the sixth month after operation, the patients showed favorable vision and no evidence of recurrence. CONCLUSIONS: In the identification of a corneal mass, a secondary, localized amyloidosis should be considered, which can be managed successfully.