Mandeville John T H, Roh Joo Heon, Woog John J, Gonnering Russell S, Levin Peter S, Mazzoli Robert A, Ainbinder Darryl J, Older J Justin, Moulin Alexandre P, Kiel Ralf, Kim Yoon-Duck, Dryja Thaddeus P
Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Ophthalmic Plast Reconstr Surg. 2004 Mar;20(2):110-6. doi: 10.1097/01.iop.0000117337.65340.e5.
To describe the clinical presentation of cutaneous benign mixed tumor of the eyelid and its management options.
Periocular cases of cutaneous benign mixed tumor were gathered from members of an oculoplastics specialty Internet discussion group. A total of 9 patients are described in this retrospective, interventional case series. The clinical presentation, histopathology, and management of these lesions is reviewed.
Patients were typically asymptomatic, presenting with a slowly enlarging, nontender nodule of 2 to 8 years' duration. The lesions ranged from 4 mm to 17 mm in greatest dimension. Four of the lesions were on the eyelid margin, three in the sub-brow area of the upper eyelid, and two in the central lids. All six cases not involving the brow were fixed to the tarsus; one brow lesion was believed to be adherent to the skin. None of the lesions was associated with significant changes of the overlying epidermis, although one lesion showed overlying pigmentation. All patients underwent excisional biopsy for diagnostic or cosmetic reasons. On histopathologic examination, the tumors were biphasic, with an epithelial component exhibiting apocrine or hair follicle differentiation and a myxoid, adipocytic, chondroid, and/or fibrous stroma. The pathologic diagnoses were all consistent with cutaneous benign mixed tumor (chondroid syringoma, pleomorphic adenoma). Follow-up ranged from 2 weeks to 12 months, although several patients failed to keep scheduled follow-up appointments. No clinical recurrences were identified.
Cutaneous benign mixed tumor may occur in the eyelid, and, although uncommon, should be included in the differential diagnosis of firm, nodular eyelid tumors. The histopathologic features are similar to those seen in this tumor type arising in other areas of the body. Preoperative consideration of this diagnostic possibility may allow the surgeon to plan for complete excision, thereby reducing the possibility of recurrence or malignant transformation.
描述眼睑皮肤良性混合瘤的临床表现及其治疗选择。
从眼整形专业互联网讨论组的成员中收集眼周皮肤良性混合瘤病例。在这个回顾性、干预性病例系列中，共描述了9例患者。对这些病变的临床表现、组织病理学和治疗进行了回顾。
患者通常无症状，表现为缓慢增大、无压痛的结节，病程为2至8年。病变最大直径为4毫米至17毫米。其中4个病变位于睑缘，3个在上睑眉下区域，2个在睑中央。所有6例未累及眉部的病变均与睑板固定；1例眉部病变被认为与皮肤粘连。尽管有1个病变有色素沉着，但所有病变均未伴有上皮显著改变。所有患者因诊断或美容原因均接受了切除活检。组织病理学检查显示，肿瘤为双相性，上皮成分表现为大汗腺或毛囊分化，伴有黏液样、脂肪细胞、软骨样和/或纤维性间质。病理诊断均符合皮肤良性混合瘤（软骨样汗腺瘤、多形性腺瘤）。随访时间为2周至12个月，尽管有几名患者未按计划进行随访预约。未发现临床复发。
皮肤良性混合瘤可发生于眼睑，虽然不常见，但在眼睑实性结节性肿瘤的鉴别诊断中应予以考虑。其组织病理学特征与身体其他部位发生的这种肿瘤类型相似。术前考虑这种诊断可能性可使外科医生计划进行完整切除，从而降低复发或恶变的可能性。
