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Letter to the Editor
Microcystic adnexal carcinoma masquerading as a chalazion
  1. J L BROOKES,
  2. C BENTLEY,
  3. S VERMA,
  4. JANE M OLVER
  1. Western Eye Hospital, Marylebone Road, London NW1
  2. Department of Histopathology, UDMS of Guy’s and St Thomas’s Hospital, London
  1. P H McKEE
  1. Western Eye Hospital, Marylebone Road, London NW1
  2. Department of Histopathology, UDMS of Guy’s and St Thomas’s Hospital, London
  1. Miss Jane M Olver.

https://doi.org/10.1136/bjo.82.2.196

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    Editor,—Microcystic adnexal carcinoma (MAC) is a locally aggressive cutaneous tumour first described by Goldsteinet al in 1982.1 This tumour has a predilection for the face2 3 with only a few cases reported involving the periocular region.4-6 It is a low grade tumour of eccrine sweat gland derivation which behaves aggressively in its growth pattern and recurrence rate. It has also been known as a sclerosing sweat duct carcinoma (SSDC). We report a case of MAC initially masquerading as a benign chalazion.

    CASE REPORT

    A 66 year old white woman attended the accident and emergency department at the Western Eye Hospital with a 2 week history of red sore eyes. Bilateral blepharitis was diagnosed and a chalazion noted at the medial end of the left lower eyelid, adjacent to the punctum. The only unusual comment made was that the chalazion had “granulation tissue” on its conjunctival surface.

    The blepharitis was treated with topical antibiotic and eyelid hygiene and she was listed for minor surgery. However, she had incision of her chalazion elsewhere and did not attend the accident and emergency department for another 18 months when she returned with recurrent symptoms of blepharitis.

    On examination, a distorted reddened lower eyelid lump was observed in the exact location of her previous “chalazion” which had apparently remained despite incision. There was some puckering of …

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