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Q. Kindly review the slides and provide a diagnosis for my mother's eyelid swelling.

Answered by
Dr. Utkarsh Sharma
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on Apr 26, 2021

Hi doctor,

I am uploading the pathology slides of my mother, who had a swelling on her left eyelid.

Kindly review the slides and provide a suitable diagnosis.

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#

Hello,

Welcome to icliniq.com.

I shall definitely try to help you with your query.

Microscopic sections studied stained with hematoxylin and eosin (H and E) show well-circumscribed dermal tumors with cellular masses separated by collagenous stroma. The tumor is made up of two types of the cell population. The predominant type of cell is round to polyhedral with finely granular faintly eosinophilic cytoplasm having a round to oval nucleus and the second type having clear cytoplasm and small eccentric nucleus. On the basis of histopathological examination, it seems a case of nodular hidradenoma. Nodular hidradenoma is also known as eccrine acrospiroma, clear cell hidradenoma and solid cystic hidradenoma.

It is a benign tumor of skin appendages that arises from the distal excretory duct of eccrine sweat glands on the skin.

Hidradenomas are unusual in the eyelids, and the possibility of this variant should be considered in the differential diagnosis of eyelid tumors.

Squamous cell carcinoma and meibomian cell carcinoma are the differential diagnosis.

An immunohistochemistry panel is suggested to confirm the diagnosis.

If you can send the gross images of the eyelid, it can help me further in diagnosis.

Take care and all the best.

Hi doctor,

Is it benign or malignant? And since the surgery has already been done, is it possible to know whether it has spread?

Thanks doctor.

#

Hello,

Welcome back to icliniq.com.

A hidradenoma can be benign or malignant. The histology of the malignant hidradenoma resembles that of its benign counterpart. The criteria for malignancy include poor circumscription, presence of nuclear atypia, mitotic activity, presence of predominantly solid cell islands, infiltrative growth pattern, necrosis, and angio-lymphatic permeation. In my opinion, this one appears benign.

Is the patient experiencing certain symptoms?

Can you share the pathology report so that I can get to know about the gross examination?

I still suggest immunohistochemistry and PAS stain so that diagnosis can be confirmed.

Take care.


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