Primary Cutaneous Mucinous Carcinoma of the Lower Eyelid

Primary cutaneous mucinous carcinoma of the eyelid is an adenocarcinoma of the eccrine glands. These tumor is a rare ocular adnexal neoplasm that has a predilection for the periorbital and scalp region. It is more common in men and occur primarily in 50-70 year-old age range. We present the occurrence, clinical and histological features, and management of this tumour in a old male, who could exclude the presence of primary mucinous carcinoma elsewhere by extensive systemic evaluation.

A 67-year-old male presented with a small nodular erythematous nontender left lower lid lesion, which had increased in size and pigmentation over four years. Pneumoconiosis was noted on preoperative chest CT, but it was correlated with his occupational history. Lymphatic involvement was not noted on physical examination. So he underwent wide local excision with frozen section control of the margins. Clear margin were achieved and the defect was repaired with a local rotation flap.

Histologic examination showed mucinous carcinoma of the eccrine glands. A whole body screening test(PET) was performed to excluded the presence of primary mucinous carcinoma elsewhere metastating to the eyelid, or any distant spread from the eyelid lesion. PET demonstrated mildly increased hypermetabolism in both lungs and hypermetabolic lymph nodes at both supraclavicular areas and mediastinum. But extensive systemic workup, including abdominal ultrasonography, upper and lower gastrointestinal endoscope, neck CT, and lung biopsyrevealed no other abnormal lesion. Immunohistochemical markers including CEA, S-100, CK-PAN, CK7, CK-20, TTF-l were also helpful in establishing the diagnosis of the primary cutaneous mucinous carcinoma of the skin. There has been no recurrence of tumor 2 months following excision.