Eyelid adenoid cystic carcinoma: An analysis of one case with clinicopathological features mimicking sebaceous gland carcinoma

Abstract

Background: Adenoid cystic carcinoma (ACC) is a rare malignant epithelial tumor representing 1–2% of all head and neck tumors and 10–15% of malignant salivary gland tumors. In the eyelid, it can arise from the glands of Moll, the palpebral lobe of the lacrimal gland, the accessory lacrimal glands in the conjunctiva, or from ectopic lacrimal gland tissue. It is the most common primary malignant epithelial tumor of the lacrimal glands and accounts for approximately 1.6% of all orbital tumors. In this case, we see adenoid cystic carcinoma arising from the skin of the eyelid with features simulating the more commonly seen sebaceous gland carcinoma.

Case: A 74-year-old male patient presented with a two-year history of swelling in the left upper lid. The lesion was excised without being sent for histology. Subsequently, there was a recurrence of the swelling, and the patient was referred to Kenyatta National Hospital. Upon admission, the working diagnosis was left upper lid sebaceous gland carcinoma, and the patient underwent a wide full-thickness excisional biopsy of the left eyelid. The histological diagnosis revealed adenoid cystic carcinoma of the eyelid. The patient then underwent lid reconstruction surgery.

Conclusion: Malignant eyelid lesions may masquerade as several different clinically benign conditions and all excised eyelid lesions should be submitted for histopathologic confirmation.