Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May;31(5):736-740.
doi: 10.1038/eye.2016.313. Epub 2017 Jan 13.

The clinical, histological and immunohistochemical characteristics and nomenclature of meibomian gland ductal cysts (intratarsal keratinous cysts) and eyelid steatocystomas

S N Rajak  1   2 , C James  2 , D Selva  1
Affiliations

The clinical, histological and immunohistochemical characteristics and nomenclature of meibomian gland ductal cysts (intratarsal keratinous cysts) and eyelid steatocystomas

S N Rajak et al. Eye (Lond). 2017 May.

Abstract

PurposeMeibomian gland ductal cysts (MGDCs) and steatocystomas are epithelial lined, keratin-containing lesions of the eyelids. MDGCs are variably called tarsal keratinous cysts, intratarsal keratinous cysts of the meibomian glands, intratarsal inclusion cysts, epidermal cysts and epidermoid cysts. Both lesions are poorly described in the literature. We report a series of seven MGDC and steatocystomas, and examine their clinical, pathological and immunohistochemistry features and their management and outcomes.Patients and methodsA retrospective review of case notes and histopathology slides of all MGDCs and steatocystomas identified at one major histopathology service in South Australia between 2013 and 2015.ResultsSeven cases were identified, with an average age of 64. The lesions range from 4 to 18 mm diameter and are firm, well-circumscribed and non-tender, and sometimes the keratin-filled cyst protrudes visibly under the tarsal conjunctiva. Two cases were previously misdiagnosed as chalazia but recurred after incision and curettage. Histologically, these lesions are lined by squamous epithelium but lack a well-formed stratum granulosum and can be distinguished by their immunohistochemical staining characteristics. Complete excision, including a wedge of underlying tarsal plate for MDGCs, is curative for with a follow up of 12-36 months.ConclusionsMGDCs and steatocystomas should be included in the differential of benign eyelid lesions. Diagnosing and differentiating these lesions from chalazia is important for determining the optimal management strategy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
External and conjunctival appearances of three meibomian gland ductal cysts (MGDC).
Figure 2
Figure 2
Surgical excision of a MGDC. (a) A skin crease incision exposes the intact keratin-filled cyst, (b) The entire cyst is excised with a wedge of underlying tarsal plate, (c) the full thickness excision is seen from the skin side.
See this image and copyright information in PMC

References

    1. Jakobiec FA, Mehta M, Iwamoto M, Hatton MP, Thakker M, Fay A. Intratarsal keratinous cysts of the Meibomian gland: distinctive clinicopathologic and immunohistochemical features in 6 cases. Am J Ophthalmol 2010; 149(1): 82–94. - PubMed
    1. Lucarelli MJ, Ahn HB, Kulkarni AD, Kahana A. Intratarsal epidermal inclusion cyst. Ophthal Plast Reconstr Surg 2008; 24(5): 357–359. - PubMed
    1. Majumdar M, Khandelwal R, Wilkinson A. Giant epidermal cyst of the tarsal plate. Indian J Ophthalmol 2012; 60(3): 211–213. - PMC - PubMed
    1. Vagefi MR, Lin CC, McCann JD, Anderson RL. Epidermoid cyst of the upper eyelid tarsal plate. Ophthal Plast Reconstr Surg 2008; 24(4): 323–324. - PubMed
    1. Kim JA, Kim N, Choung HK, Lee MJ, Lee C, Khwarg SI. Clinical features of intratarsal keratinous cysts. Eye 2016; 30(1): 59–63. - PMC - PubMed

MeSH terms