Primary localised deep cutaneous amyloidosis of the eyelid.Malays J Pathol. 2005 Dec;27(2):113-5.

 A 62-year-old lady presented with a six-month history of swelling of the left upper eyelid, resulting in mild mechanical ptosis. Clinical assessment suggested a provisional diagnosis of dermoid cyst. The lesion was excised and histology revealed nodular deposits of amorphous eosinophilic material surrounded by lymphocytes and plasma cells. Special histochemistry and immunoperoxidase stain results showed deposition of amyloid, non-AA type. The lesion recurred 6 months later.

Nodular cutaneous amyloid tumors of the eyelids in the absence of systemic amyloidosis. Ophthalmic Surg Lasers. 2001 Sep-Oct;32(5):422-4.

A patient was referred with recurrent bilateral, slow-growing, painless, nodular tumors of the upper eyelid margins. The tumors were excised and the base of each lesion was ablated with the CO2 laser. Histological examination of the excised tissue revealed amyloid. Despite the fact that cutaneous, amyloid lesions of the eyelid have been previously described as essentially pathognomonic for systemic amyloid disease, no evidence of systemic amyloidosis was found in this patient. We believe that this represents only the second reported case of bilateral cutaneous amyloid of the eyelids without systemic involvement. We agree with previous authors that this lesion be added to the list of painless slow-growing bilateral eyelid tumors.

Primary localized amyloidosis presenting as an eyelid margin tumor.Arch Ophthalmol. 1986 Apr;104(4):584-5

A 40-year-old man had slow-growing, nodular, amyloid tumors of the eyelid margin associated with recurrent intradermal hemorrhages for 18 years. Medical evaluation revealed no evidence of primary systemic amyloidosis. We suggest that amyloidosis be included in the differential diagnosis of painless, slow-growing, nodular tumors of the eyelid margin.

Metastatic mucinous carcinoma of the eyelid. Malays J Pathol 2005 Dec;27 (2):117-8.

Metastatic eyelid tumours are rare and account for less than 2% of all eyelid neoplasms. We report a case of metastatic breast carcinoma to the eyelid in a 60-year-old Chinese lady presenting with a 2-year history of enlarging, painless nodular lower eyelid swelling. The 1 cm diameter lesion was provisionally diagnosed as a sebaceous cyst. However the excision biopsy revealed a mucinous carcinoma expressing oestrogen receptor protein. She had a past history of mastectomy one year previously and histology showed an infiltrating ductal carcinoma (oestrogen receptor status negative) without evidence of axillary lymph node metastasis. She had completed adjuvant radio- and chemotherapy. Further treatment of the current lesion involved a wide excision which did not show any residual malignancy. She had no other evidence of metastasis and was treated with letrozol. We highlight this case to create awareness among clinicians and opthalmologists on the possibility of metastatic disease as a cause of eyelid swelling, especially in patients with a history of cancer. It may also be the first sign of metastatic disease of an internal malignancy. A review of the literature is also presented.

Eyelid metastasis from lung carcinoma.Clin Experiment Ophthalmol. 2006 Aug;34(6):609-10.

A 74-year-old man presented with a 4-month history of swelling in the right upper lid. Biopsy of the lesion showed moderate to poorly differentiated invasive squamous cell carcinoma. He was recently diagnosed with squamous carcinoma of the lung with similar histology to the eyelid lesion. Eyelid metastases are a rare presentation of lung tumours.

Metastatic disease first presenting as eyelid tumors: a report of two cases and review of the literature.Ann Ophthalmol. 1987 Jan;19(1):13-8

We present two unusual cases in which an eyelid tumor was the first sign of metastatic disease. The first involved a 53-year-old man with pulmonary carcinoma and the second a 71-year-old man with malignant lymphoma. Fifteen similar cases from the literature are reviewed. The most frequent primary lesion is breast carcinoma in women, which appears as a diffuse lesion of one or two eyelids. Metastatic lung carcinoma in men appears as solitary nodules, representing the second-most common type of lesion. The questions of left- or right-side predominance, age and sex of patients, types of tumors, and prognosis are discussed.

Histopathological classification of 3,510 cases with eyelid tumor.
Zhonghua Yan Ke Za Zhi. 1996 Nov;32(6):435-7.

OBJECTIVE: To study the histopathological classification of eyelid tumor. METHOD: The pathological specimens of 3,510 cases with eyelid tumor examined between 1953-1992 were retrospectively analyzed. RESULTS The 5 leading malignant lid tumors were basal cell carcinomas (430 cases, 37.6%), meibomian gland carcinomas (363, 31.7%), squamous cell carcinomas (216 cases, 18.9%), melanomas (56 cases, 4.9%) and malignant lymphomas (21 cases, 1.8%). The 5 leading benign lid tumors including papillomas (658 cases, 27.9%), pigmented nevi (578 cases, 24.4%), cysts (427 cases, 18.1%), angiomas (222 cases, 9.4% including 10 lymphangiomas) and verrucae (212 cases, 9.0%). Rare tumors of the eyelid included one case of each of the following tumors: reticulum cell sarcoma, adenocystic carcinoma, malignant mesenchymoma, mucinous adenocarcinoma, Bowen's disease, basosquamous carcinoma, basosebacious carcinoma, teratoma, granular cell tumor (myoblastoma), angiolymphoid hyperplasia with eosinophilia, osteoma, etc. CONCLUSION: The classification and differentiation in type of eyelid tumor are beneficial to the histopathological diagnosis.

Tumors of the eyelids in the elderly.J Fr Ophtalmol. 2006 Jun;29(6):687-93.

The clinical aspect of tumors of the eyelids is polymorphous; however, the most frequent are benign tumors such as papillomas, basal cell carcinoma, squamous cell carcinoma, meibomian gland carcinoma, and melanomas. An important step in the management of the malignant types is to try to establish clear margins through histopathologic techniques: the Mohs technique, the rapid fixation technique, and the frozen section method are the most frequent technical tools used today. For the most malignant tumors such as malignant melanoma and Merkel cell tumor, lymph sentinel biopsy is a recent, valuable tool, but its benefit needs to be confirmed in large series.

Management of malignant and benign eyelid lesions.Curr Opin Ophthalmol. 2006 Oct;17(5):480-4

PURPOSE OF REVIEW: The management of benign and malignant eyelid neoplasms has been extensively examined. This paper offers an overview of the most common eyelid lesions and their management based on a review of the relevant bibliography. RECENT FINDINGS: Recent studies have focused on the results of nonsurgical approaches for benign and premalignant lesions that are routinely surgically excised. In the malignant group, a consensus has been reached over the preferred method of tumor excision for basal cell carcinoma: Mohs surgery or complete surgical excision with frozen-section control of the margins offers the lowest tumor-recurrence rate. Important acquisitions have been made on squamous cells for which sentinel node biopsy may reveal early metastatic cancer. Intraepithelial tumor growth is a peculiar feature of sebaceous gland carcinoma that seems to indicate an increased risk for orbital invasion. Recent reports regarding the rare tumor, Merkel cell carcinoma, recommend a wide surgical excision with 5 mm margins; this may reduce the incidence of lymph-node metastasis, haematogenous spread and local recurrences. SUMMARY: Although treatment of the most common benign and malignant tumours affecting the eyelids has not radically changed over the years, recent reports have significantly improved the standard of care for affected patients.

Benign pigmented lesions of the eyelids.J Fr Ophtalmol. 2005 Oct;28(8): 889-95

We describe benign pigmented tumors of the lids, including benign lesions of the epithelium such as papillomas, seborrheic keratosis, and inverted follicular keratosis; precancerous lesions of the epithelium such as xeroderma pigmentosum and actinic keratosis; melanocytic lesions such as Ota nevus, lentigo, and lentigo maligna; and nevi and other lesions simulating a melanoma such as pigmented hidrocystoma, angiomas, and epithelial cyst. For each of these lesions, we describe the clinical and histopathological aspect as well as the therapeutic guidelines.

Clinicopathological analysis of malignant eyelid tumor cases at Yamagata university hospital: statistical comparison of tumor incidence in Japan and in other countries.Jpn J Ophthalmol. 2005 Sep-Oct;49(5):349-54

PURPOSE: To report the clinical and histopathological features of malignant eyelid tumor cases treated in our clinic. We also compared the differences in the frequency of malignant eyelid tumor in various regions of Japan and worldwide. METHODS: Retrospectively, we studied the records of the 38 cases of malignant eyelid tumor treated in Yamagata University Hospital over the last 17 years. The statistical comparison with various countries was based on reports of case studies in those countries. RESULTS: Data from our clinic: Among the total of 38 cases, 15 cases (39.5%) were diagnosed as basal cell carcinoma, 11 cases (28.9%) as sebaceous gland carcinoma, and 4 cases (10.5%) as squamous cell carcinoma. In addition, three cases were malignant melanoma, two adenocarcinoma, one Merkel cell carcinoma, one malignant peripheral nerve sheath tumor, and one malignant lymphoma. The ages of patients ranged from 45 to 92 years (mean, 72.0 +/- 12.4 years). Most of the cases were treated by complete resection of the tumors and eyelid reconstruction. Radiation or cryotherapy were added when required. The prognosis of the cases with basal cell carcinoma and squamous cell carcinoma was good, and that of the other tumors was relatively poor. During the same period, in Caucasians, basal cell carcinoma constituted about 80%-90% of the malignant eyelid tumors, whereas in Japan and Asian countries, basal cell carcinoma, sebaceous gland carcinoma, and squamous cell carcinoma each constituted about 20%-40%. CONCLUSIONS: A racial difference in the incidence of basal cell carcinoma, sebaceous gland carcinoma, and squamous cell carcinoma can be considered in making a diagnosis.

Eyelid tumors in Siriraj Hospital from 2000-2004. J Med Assoc Thai.2005 Nov;88 Suppl 9:S11-4

OBJECTIVES: To determine the relative incidence of eyelid lesions seen in Siriraj Hospital from January 2000-April 2004. STUDY DESIGN: Retrospective charts review MATERIAL AND METHOD: Two hundred and ninety-seven cases of eyelid lesions seen in Siriraj Hospital from 2000 to 2004 were analyzed. RESULTS: There were 53 (17.8%) inflammatory conditions, 212 (71.4%) benign eyelid tumors and 32 (10.8%) malignant eyelid tumors. These 32 malignant eyelid tumors included 13 sebaceous gland carcinomas, 12 basal cell carcinomas, 3 malignant melanomas, 2 squamous cell carcinomas, 1 apocrine adenocarcinoma and 1 metastatic carcinoma. Various flaps techniques or primary closures were used for reconstruction in 20 cases. Six cases needed exenteration. CONCLUSION: The majority of eyelid lesions were benign eyelid tumors while malignant eyelid tumors contributed 10.8% of the total eyelid lesions. Sebaceous gland carcinoma was the most common eyelid tumor found in their present study that was consistent with other studies from Asian countries.

Malignant eyelid tumours in Taiwan. Eye. 2003 Mar;17(2):216-20

AIMS: To describe the clinical characteristics of patients with eyelid cancers in Taiwan. METHODS: Between 1980 and 2000, 127 (58 males and 69 females) patients (mean age 62.6; range 10-91 years) with histologically confirmed eyelid cancers were retrospectively evaluated at the National Taiwan University Hospital and Far Eastern Memorial Hospital in Taiwan. Clinical data of all patients were reviewed from medical records. The mean follow-up period was 62.4 months (range 3-240) for 113 patients. RESULTS: The 127 eyelid cancers included 79 basal cell carcinomas (62.2%), 30 sebaceous gland carcinomas (23.6%), 11 squamous cell carcinomas (8.7%), five malignant melanomas (3.9%), one Kaposi's sarcoma (0.8%), and one metastatic cancer (0.8%). Tumours developed more commonly in the lower (37.0%) than the upper eyelid (33.9%). The clinical accuracy in predicting eyelid malignancy was 90.5%. Primary treatment modality was mainly surgical excision. The recurrence, metastasis, and mortality rates at 5 years were 15.2, 11.7, and 7.3%, respectively, for all eyelid malignancies. Rates of sebaceous gland carcinoma recurrence, metastasis, and mortality were significantly higher (P<0.05) than those of basal cell carcinoma. The mean interval of recurrence or metastasis after primary treatment was 26.3 months (range 4-112) for all eyelid cancers. CONCLUSIONS: Although basal cell carcinoma is the most common eyelid cancer in Taiwan, sebaceous gland carcinoma is also common. Of the two, basal cell carcinoma has a better prognosis and sebaceous gland carcinoma has a higher mortality and therefore should be treated much more aggressively. Long-term follow-up is needed after treatment of malignant eyelid tumours.

Malignant tumors of the eyelid: a population-based study of non-basal cell and non-squamous cell malignant neoplasms.Arch Ophthalmol.1998 Feb;116(2):195-8.

OBJECTIVE: To determine the relative frequencies, average annual incidences, and patient characteristics of non-basal cell and non-squamous cell malignant neoplasms of the eyelid in a defined geographic population. DESIGN and SETTING: A retrospective study using the Florida Cancer Data System to identify malignant tumors of the eyelid, except for basal cell and squamous cell carcinomas, from 1981 through 1994. Cases were limited to persons who resided within Florida. MAIN OUTCOME MEASURE: Incidence of histologically confirmed malignant eyelid tumors. RESULTS: Two hundred six primary malignant eyelid tumors were identified. The 3 most common, in order of frequency, were melanoma, sebaceous carcinoma, and lymphoma. The median age at diagnosis for all patients was 73 years. Only 3 of the 206 malignant neoplasms occurred in blacks. The annual incidence of eyelid melanoma and sebaceous carcinoma in whites older than 20 years was 0.6 and 0.5 per million, respectively. Kaposi sarcoma was the most common type of mesenchymal tumor. Eleven different histologic types of lymphoma were found in the eyelid. Only 2 of 27 lymphomas had T-cell lineage. CONCLUSIONS: Malignant tumors of the eyelid other than basal cell and squamous cell carcinoma are uncommon and usually occur in elderly white persons. Primary eyelid tumors of any type are rare in blacks. The risk of a non-basal cell and non-squamous cell malignant neoplasm of the eyelid in Florida is 6.4 times greater for whites than for blacks (95% confidence interval [CI], 2.1-20.2). A variety of B-cell lymphomas can be manifested as primary eyelid tumors.

The clinicopathological spectrum of benign peripunctal tumours.Graefes Arch Clin Exp Ophthalmol. 2005 Feb;243(2):113-9. Epub 2004 Nov 19.

PURPOSE: Because of the rarity of peripunctal tumours and their clinical classification as conjunctival or eyelid tumours, they have gained little attention in the literature. We conducted a retrospective study to illustrate the different clinical and histopathological spectrum of peripunctal tumours seen at two oculoplastics clinics. METHODS: In a retrospective interventional clinicopathologic case series study, all the charts of patients with peripunctal tumours presented at an ophthalmic oncology clinic in Jerusalem, Israel and an oculoplastics clinic in Boston, USA were reviewed. The tumours were classified as epithelial and non-epithelial tumours. The symptoms caused by these tumours, their pattern of growth and their management were evaluated. RESULTS: Fourteen peripunctal tumours were identified. Eleven out of 175 (6.3%) peripunctal disorders and out of approximately 4,000 (0.27%) surgical oculoplastics patients were seen at Massachusetts Eye & Ear Infirmary, Boston. Three were seen at Hadassah University Hospital, Jerusalem. Seven histopathological types of peripunctal tumours of epithelial, subepithelial or melanocytic origin causing punctal occlusion or displacement were identified. The tumours included compound and junctional naevi, non-pigmented compound naevus, epithelial, subepithelial inclusion cysts, verrucous and squamous papilloma, pyogenic granuloma and oncocytoma. All the tumours were benign. They involved the peripunctal or canalicular epithelium, the adjacent skin, the glandular epithelium or the subepithelium. They presented as a peripunctal mass or were accidentally disclosed but none of them resulted in epiphora. CONCLUSIONS: Peripunctal tumours are rare. They exhibit different clinical types of growth and may be difficult to diagnose based on their clinical appearance alone. The location of peripunctal tumours potentially allows their extension from the conjunctival sac into the canaliculus and vice versa. Therefore, it is best to ascertain free margins when the tumour is excised.

Cardiac Path Online;

Pulmonary Pathology Online

Pathology Quiz Online;

Cutaneous Pseudolymphoma

Cutaneous infection and infestations

Histopathological patterns in cutaneous infections

1: Bacterial, Rickettsial and Chlamydial infection

2: Spirochetal Infection

3 : Mycoses and algal infections

4 : Protozoal Infections

5 : Helminth Infections

 6: Viral Infections

Cutaneous lesion associated
with AIDS

Acquired Melanocytic Naevus

Ancient Naevus

Halo naevus

Balloon cell naevus

Mongolian Spots /Ota's naevus /Ito's naevus

Blue naevus-variants

Deep penetrating naevus  

Combined Naevus

Recurrent naevus

Spitz naevus

Dysplastic naevus

Congenital naevus

Spindle cell naevus

Pigmented melanocytic lesions causing diagnostic problems

Prognostic parameters of melanoma

Lentigo maligna melanoma

Superficial spreading melanoma

Nodular melanoma

Acral lentiginous melanoma

Desmoplastic /Spindle cell /Neurotropic melanoma

Naevoid melanoma

Balloon cell melanoma