Endocrine mucin-producing sweat gland carcinoma of the eyelid: A clinical and histological conundrum

A 60-year-old male presented with a 6-month-old history of a left upper lid mass. The mass was excised, and histopathological evaluation showed a well-circumscribed, multinodular, intradermal tumor consisting of round-to-oval cells with round nuclei and mucin filled cysts. On immunohistochemical analysis, the tumor cells stained positively for cytokeratin (CK)-7, CK-8, estrogen receptor (ER), progesterone receptor (PR), mucicarmine, synaptophysin, gross cystic disease fluid protein-15 (GCDFP-15), and neuron-specific enolase (NSE). A diagnosis of endocrine mucin-producing sweat gland carcinoma (EMPSGC) of the eyelid was made and at 6-month follow-up, no recurrence was noted. In this communication, we discuss the pathology and treatment options of EMPSGC of the eyelid. Although an uncommon entity, EMPSGC may be considered as a differential when encountered with a suspicious, potentially malignant eyelid mass.

A Case of Full-thickness Lower Eyelid Reconstruction by a Tenzel Flap / 대한피부과학회지

Because the width of the intact eyelid is narrow, tumor removal with a 5 mm or greater margin is not amenable to direct closure. A semicircular flap, first described by Tenzel in 1975, has been widely used for eyelid reconstruction, although it may be unfamiliar to dermatologists. The flap is made by creating a semicircular skin-muscle flap laterally, performing a lateral canthotomy and inferior cantholysis, cutting the lateral attachments of the septum and then advancing the flap medially to close the defect. The advantage of the semicircular flap is that defect closure is possible while maintaining the lid and its lashes. In addition, it is a one-step procedure, which is simple and efficient. We present a case of basal cell carcinoma that involved the skin of the left lower eyelid. The defect measured 0.9 cm in breadth. After a wide excision, it was successfully managed using a Tenzel flap with excellent cosmetic and functional results.

The Effects of Tenzel Operation on Cicatricial Entropion

Tarsus wedge resection and lid margin splitting with recession. Tenzel operation, were performed for cicatricial entropion of seventeen eyelids in twelve patients. The ages ranged from 10 to 68 years(mean, 45.1 years). Seven patients were women and five patients were men. The causes of entropion were chemical burn, thermal burn, ocular pemphigus and previous lid operations All patients were satisfied with good cosmesis, functional results without recurrences and improvement of tearing, ocular pain and photo-phobia after the follow-up period of 3 to 36 months. The advantages of Tenzel operation over other methods were simplicity, excellent cosmetic and functional effects and less recurrence. Therefore, Tenzel operation is recom mended as the method of choice for cicatricial entropion.

A Clinical Study on Implantation of Anterior Chamber Intraocular Lens and Posterior Chamber Intraocular Lens by Scleral Fixation in Eyes without Capsular or Zonular Support

The study was performed retrospectively to compare the results of anterior chamber IOL(Intraocular Lens) implantation and posterior chamber IOL implantation by scleral fixation in cases of inadequate zonular or capsular support during the extracapsular cataract extraction. A total of 27 cases were reviewed of which 11 cases had anterior chamber IOL implantation and 16 cases had posterior chamber IOL implantation by scleral fixation. The follow-up period ranged from two to twenty-four months. Nine of eleven in anterior chamber IOL group and thirteen of sixteen in posterior chamber IOL group had the final corrected vision of 0.5 or better. Vision-threatening complications included two cases of cystoid macular edema in anterior chamber IOL group, whose visual acuity was 0.1 and 0.5, and three cases of vitreous hemorrhage in posterior chamber IOL group, which had little effect on visual outcome The final visual acuity didn't show statistically significant difference between the two groups.

Eyelid Reconstruction by the Semicircular Flap

Upper and lower eyelid defects of 40-60% can be reconstructed by the Tenzel semicircular flap technique. Lower eyelid defects of 75-80% can be successfully corrected if the lower eyelid retractors and inferior orbital septum are severed from their attachment. This technique provides several distinct advantages. It is useful for reconstruction of both the upper and lower eyelids. It can be accomplished without borrowing tissues from other sites. It provides a length about 1.5 times greater than would be available along the straight line diameter. The indications for the use of this procedure included basal cell carcinoma(4 cases), compound nevus(1 case), post-traumatic eyelid deformity(2 cases). We obtained cosmetically good results in all cases without any senous postoperative complications.