Pathology of eyelid tumors

Abstract

The eyelids are composed of four layers: skin and subcutaneous tissue including its adnexa, striated muscle, tarsus with the meibomian glands, and the palpebral conjunctiva. Benign and malignant tumors can arise from each of the eyelid layers. Most eyelid tumors are of cutaneous origin, mostly epidermal, which can be divided into epithelial and melanocytic tumors. Benign epithelial lesions, cystic lesions, and benign melanocytic lesions are very common. The most common malignant eyelid tumors are basal cell carcinoma in Caucasians and sebaceous gland carcinoma in Asians. Adnexal and stromal tumors are less frequent. The present review describes the more important eyelid tumors according to the following groups: Benign and malignant epithelial tumors, benign and malignant melanocytic tumors, benign and malignant adnexal tumors, stromal eyelid tumors, lymphoproliferative and metastatic tumors, other rare eyelid tumors, and inflammatory and infections lesions that simulate neoplasms.

Figure 1

Squamous papilloma presenting as a papillary lesion in the upper lid margin

Figure 2

Histopathology picture of papillomatous lesion showing epithelial acanthosis and some hyperkeratosis with a central fibrovascular core (H and E, ×4)

Figure 3

Basal cell carcinoma of the lower eyelid presenting as an elevated ulcerated nodule

Figure 4

Histopathology pictures of a solid-type of basal cell carcinoma composed of nodules of epithelial tumor cells lined by peripheral palisading of the nuclei (H and E, ×10)

Figure 5

Clinical picture of a “split nevus,” also known as “kissing nevus”

Figure 6

Oculodermal melanocytosis, known as nevus of Ota, showing unilateral bluish discoloration of the eyelid and periorbital skin and blue scleral discoloration

Figure 7

Apocrine hidrocystoma presenting as a bluish cyst

Figure 8

Histopathological picture of apocrine hidrocystoma showing cystic spaces lined by inner columnar epithelium that displays typical eosinophilic apical cytoplasm – the decapitation secretion, surrounded by outer myoepithelial cells (H and E, ×40)

Figure 9

Eccrine hidrocystoma in the lateral canthus

Figure 10

Histopathological picture of eccrine hidrocystoma showing cystic spaces lined by two layers of cuboidal epithelium (H and E, ×10)

Figure 11

Sebaceous gland carcinoma of the upper eyelid presenting as red thickening of the upper eyelid with loss of eyelashes

Figure 12

Histopathological picture of sebaceous gland carcinoma of the meibomian gland stained with Oil Red O (×10)

Figure 13

Diffuse infantile capillary hemangioma covers the left side of the face

Figure 14

Histopathologic pictures of capillary hemangioma showing lobules of capillaries separated by fibrous tissue (H and E, ×4)

Figure 15

Histopathological picture of phakomatous choristoma showing cataractous lens tissue surrounded by epithelium, embedded in fibrous tissue (H and E, ×40)

Figure 16

Histopathological pictures of a chalazion showing formation of granulomas around clear spaces representing lipid globules (H and E, ×25)

Figure 17

Histopathological picture of molluscum contagiosum showing typical globules of cells filled with intracytoplasmic eosinophilic “molluscum bodies” (H and E, ×40)