Awad John, Cheung David
Mr. Awad is with New Cross Hospital in Wolverhampton, England. Mr. Cheung is with Russell Hall Hospital in Dudley, England.
J Clin Aesthet Dermatol. 2021 Apr;14(4):24-26. Epub 2021 Apr 1.
Sweat gland carcinomas can be of eccrine or apocrine origin, with the former being more common in the eyelid. They can also be of three different types, the most common of which is mucin-producing sweat gland carcinoma, which is most often a low-grade malignancy. Here, we report a case of a primary estrogen receptor-positive eccrine adenocarcinoma of the eyelid that clinically presented like a cyst of Moll. Importantly, in our experience with this lesion, this rare malignancy was repeatedly misdiagnosed as less sinister lesions, surgical resection margins of the lesion could be easily underestimated, and close liaison with our general surgical colleagues was vital to exclude more common breast carcinoma. This case highlights the dangers of referral recommendation policies (e.g., procedures of limited clinical value as used by primary care) and the importance of incisional biopsy in the management of periocular lesions.
汗腺癌可起源于小汗腺或大汗腺，前者在眼睑更为常见。它们也有三种不同类型，其中最常见的是产生黏液的汗腺癌，通常为低度恶性。在此，我们报告一例原发性雌激素受体阳性的眼睑小汗腺腺癌，其临床表现类似睑缘腺囊肿。重要的是，根据我们对该病变的经验，这种罕见的恶性肿瘤多次被误诊为恶性程度较低的病变，病变的手术切缘很容易被低估，与普通外科同事密切联络对于排除更常见的乳腺癌至关重要。该病例凸显了转诊推荐政策（如基层医疗中使用的临床价值有限的程序）的风险以及手术活检在眼周病变管理中的重要性。
