Segal Avichai, Segal Nili, Gal Andrew, Tumuluri Krishna
Oculoplastic Surgery Unit, Sydney Eye Hospital, Sydney, New South Wales, Australia.
Orbit. 2010 Dec;29(6):334-40. doi: 10.3109/01676830.2010.516469.
To review the medical literature on mucinous sweat gland adenocarcinoma of the eyelid (MSA) and present two new cases.
Details of published case reports and small series (between 1971-2010) were evaluated and summarized including two patients diagnosed and treated at our institution. Data regarding age, gender, ethnicity, precise location, clinical presentation, treatment and follow up of each patient were collected.
25 reports describing 55 patients were found in the medical literature. The mean age was 61.3 years (30-87), 22(59%) were male and 28(80%) were Caucasian. In 23(44.2%) patients the lesion was in the lower lid, in 20(38.5%) in the upper lid, in 3(5.7%) involving both lids and in 6(11.6%) in a canthus. In 12(21.8%) patients a lesion with a benign diagnosis was previously excised from the same location. In 2 of them histological re-examination resulted in a diagnosis of MSA. Intraorbital involvement was found in 2(3.6%) patients. Regional lymph node metastasis was found in 2(4.4%) patients. Surgical excision was the treatment of choice using Mohs' micrographic-controlled excision technique in recent years. Radiotherapy was applied to 2 patients with clinical resolution in 1. Recurrence of the tumor was reported in 14(30%) patients.
MSA is a rare tumor of the eyelid with no clinically distinguishing features. It should be suspected particularly with recurrent eyelid lesions and must be differentiated from metastatic disease. The tumor may extend into the orbit and metastasize regionally. Surgical removal with continued regular follow-up examination is the treatment of choice.
回顾关于眼睑黏液性汗腺腺癌（MSA）的医学文献并报告两例新病例。
对已发表的病例报告及小样本系列研究（1971 - 2010年间）的详细信息进行评估和总结，包括在我们机构诊断和治疗的两名患者。收集每位患者的年龄、性别、种族、确切位置、临床表现、治疗及随访数据。
在医学文献中发现25篇描述55例患者的报告。平均年龄为61.3岁（30 - 87岁），男性22例（59%），白种人28例（80%）。23例（44.2%）患者病变位于下睑，20例（38.5%）位于上睑，3例（5.7%）累及双眼睑，6例（11.6%）位于眦部。12例（21.8%）患者曾在同一部位切除过诊断为良性的病变。其中2例经组织学复查诊断为MSA。2例（3.6%）患者发现眶内受累。2例（4.4%）患者发现区域淋巴结转移。近年来，手术切除是首选治疗方法，采用莫氏显微控制切除技术。2例患者接受放疗，1例临床症状缓解。14例（30%）患者报告肿瘤复发。
MSA是一种罕见的眼睑肿瘤，无临床特征性表现。尤其对于复发性眼睑病变应高度怀疑，必须与转移性疾病相鉴别。肿瘤可扩展至眼眶并发生区域转移。手术切除并持续定期随访检查是首选治疗方法。
