Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu-shi 501-1194, Japan.
BMC Ophthalmol. 2014 Jun 27;14:85. doi: 10.1186/1471-2415-14-85.
To report a rare case of a recurrence of spiradenoma that developed in the upper eyelid.
A 49-year-old woman who had a second recurrence of a tumor in the right palpebral conjunctiva underwent local resection of the lesion with adjunctive cryotherapy to the surgical site. The tumor consisted of smooth, round to oval nodular lesions approximately 1-3 mm in size with enlarged blood vessels. Histopathologically, the solid and well-circumscribed nodule was located beneath the conjunctival epithelium. It was composed of cells with slightly basophilic-to-clear cytoplasm and round-to-oval nuclei arranged in a trabecular pattern. Periodic acid-Schiff stain was positive in the cytoplasm, and the staining disappeared after digesting by diastase. Many cells in mitosis were observed throughout the tumor but no necrotic cells. Immunohistochemistry showed that the Ki-67 labeling index was 12%. From these findings, we diagnosed this tumor as a recurrence of the spiradenoma. There has been no recurrence and no signs of malignancy in the 6 months after the surgical excision.
Our findings indicate that a spiradenoma should be completely excised surgically because of malignant transformation after repeated recurrences.
报告一例罕见的发生在上眼睑的螺旋腺瘤复发病例。
一名 49 岁女性因右眼睑结膜的肿瘤第二次复发，接受了病变的局部切除术，并辅助对手术部位进行冷冻疗法。肿瘤由大小约 1-3mm 的光滑、圆形至椭圆形结节状病变组成，伴有增大的血管。组织病理学上，位于结膜上皮下的实性、边界清楚的结节由细胞组成，细胞质略带嗜碱性至透明，细胞核呈圆形至椭圆形，排列呈小梁状。过碘酸-雪夫染色在细胞质中呈阳性，用淀粉酶消化后染色消失。整个肿瘤中观察到许多有丝分裂的细胞，但没有坏死细胞。免疫组织化学显示 Ki-67 标记指数为 12%。根据这些发现，我们诊断该肿瘤为螺旋腺瘤的复发。在手术切除后 6 个月内，没有复发，也没有恶性迹象。
我们的发现表明，由于多次复发后的恶性转化，螺旋腺瘤应通过手术完全切除。
