McKinnon Elizabeth L, Rand Andrew J, Proia Alan D
Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA.
Am J Ophthalmol Case Rep. 2018 Jan 4;9:103-105. doi: 10.1016/j.ajoc.2018.01.009. eCollection 2018 Mar.
To describe the ophthalmic symptoms and histopathological findings in a rare case of an eyelid mastocytoma in an adult.
A man in his early 60s developed a painless, non-tender, non-pruritic, mobile nodule on the right lower eyelid beneath the inferior orbital rim. The lesion grew to 15 × 9 mm over eleven months. Biopsy revealed a diffuse infiltrate of histiocytoid and spindle-shaped mast cells forming cords and small nests between collagen fibers in the superficial and deep dermis. Mast cell lineage was confirmed by immunohistochemistry. Physical examination revealed no other cutaneous lesions and no evidence of systemic disease. Serum tryptase level was normal. Annual full-body examination by a dermatologist for 4.5 years has revealed neither recurrence in the eyelid nor cutaneous involvement at other sites.
Mast cell tumors limited to the human eyelid are extremely uncommon with only four previously reported cases, including one in an adult. This case highlights the rare possibility of a solitary mastocytoma presenting in the eyelid of an adult.
描述1例成人眼睑肥大细胞瘤罕见病例的眼部症状和组织病理学表现。
一名60岁出头的男性患者右下眼睑眶下缘下方出现一个无痛、无压痛、无瘙痒、可活动的结节。该病变在11个月内长至15×9毫米。活检显示组织细胞样和梭形肥大细胞弥漫浸润,在浅表和深部真皮的胶原纤维之间形成条索和小巢状结构。免疫组织化学证实为肥大细胞谱系。体格检查未发现其他皮肤病变,也无全身疾病证据。血清类胰蛋白酶水平正常。皮肤科医生进行了4.5年的年度全身检查,未发现眼睑复发或其他部位皮肤受累情况。
局限于人类眼睑的肥大细胞肿瘤极为罕见,此前仅报道过4例,其中1例为成人病例。该病例突出了成人眼睑出现孤立性肥大细胞瘤这种罕见的可能性。