Primary Cutaneous Anaplastic Large Cell Lymphoma of the Lower Lid

PURPOSE: Primary cutaneous anaplastic large cell lymphoma is rarely encountered in the lower eyelids. We report a patient with primary cutaneous anaplastic large cell lymphoma arising from the lower eyelid. METHODS: A 39-year-old man presented with a relatively fast growing mass on the center of his left lower eyelid for one month. The mass did not respond to local injection of triamcinolone at a local clinic. The lesion appeared as a solitary reddish nodule with ulceration, was non-tender, round, crusted, and measured 13 mm x 11 mm x 5 mm. Well- developed superficial vessels were found on the surface of the nodule. An incisional biopsy was performed. RESULTS: Histologic examination revealed that the bulk of the infiltrate was in the papillary and reticular dermis. Tumor cells had abundant, well-defined cytoplasm and pleomorphic nuclei with multiple nucleoli. The majority of the neoplastic cells showed immunoreactivity for CD 30 (Ki-1) along the cell membrane. A histopathological diagnosis of primary cutaneous anaplastic large cell lymphoma was made. CONCLUSIONS: Most cases of primary cutaneous anaplastic large cell lymphoma arise from the body and extremities. However, since primary cutaneous anaplastic large cell lymphoma may occur in the eyelid, it should be differentiated from nodular and relatively fast growing inflammatory tumors despite local steroid treatment.

Chondroid Syringoma of The Eyelid

PURPOSE: Chondroid syringoma is a rare tumor of the skin which arises from apocrine and eccrine glands. We report a case of chondroid syringoma arising from upper eyelid. METHODS: A 73-year-old man with a slowly growing mass on the center of right upper eyelid. Ocular examination revealed a smooth, firm, well-circumscribed and pink colored nodule measuring 15 by 17 mm in the right upper lid. Well developed superficial vessels were found on the surface of the nodule. Neither tenderness nor ulceration was accompanied. Total excision of the tumor and upper lid reconstruction with posterior auricular skin graft were done. RESULTS: Histologic examination revealed numerous glandular structures which were composed of two layers of epithelium and were scattered in abundant fibromyxoid and chondroid stroma. The histopathological diagnosis was chondroid syringoma. CONCLUSIONS: Since chondroid syringoma may occur in the eyelid, and although uncommon, it should be included in the differential diagnosis of firm and nodular tumors. The surgeon should plan for complete excision to reduce the possibility of recurrence or malignant transformation.