Apocrine adenocarcinoma arising in Moll gland cystadenoma.

Abstract

An 85-year-old woman had a bluish tumor medially on the margin of the left upper eyelid. Malignant melanoma of the conjunctiva was presumed; the lesion was excised and submitted for routine histopathologic examination. There are no signs of recurrence or metastatic disease after follow-up for 1 year. Light microscopy with routine and histochemical stains were used for diagnosis. Immunohistochemical analysis included the use of a broad-spectrum "cocktail" of cytokeratin antibodies (AE1/AE3). The features were those of a cystic cavity lined with apocrine epithelium in one part infiltrating the wall and consistent with an apocrine adenocarcinoma derived from a Moll gland cystadenoma. Malignant Moll gland tumors are extremely uncommon but may be confused with conjunctival malignant melanoma or metastatic disease. The differential diagnosis to other sweat gland tumors such as eccrine adenocarcinoma and benign apocrine tumor or to sebaceous carcinoma can be difficult.