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.

Microvascular anastomosis has become an essential technique m reconstructive surgery. A patent microvascular anastomosis is required for the success of a free tissue transfer. As the application of microsurgery grows, the desirability of performing an end to end and end to side anastomosis continues to be debated. This experimental study presents the comparison of patency rate of two types of microvascular anastomosis techniques : side to side anastomosis and end to end anastomosis.

A comparative study was undertaken to evaluate side to side micro anastomosis technique using intraluminal catheter. In this study, two clinical metods of microvascular anastomosis were compared. We compared the patency rate and time required for anastomosis. Histological changes (postoperative 1 weeks) were also invsetigated.

Postoperative patency rate was 90% by side to side technique compared to 100% by end to end technique at immediate postoperative and postoperative two weeks. This study revealed that there was no significant difference in patency rate among end to end suture method group and side to side suture method group. Microscopically, we found the relatively smooth surface of the anastomosis site with endothelial regeneration and partial hyaline degeneration in the group using side to side anastomotic method.

We believe there are many advantages in this side to side technique by using intraluminal catheter in perforater flap field and can be highly competitive to the other microvascular anastomisis techniques.