Signet ring cell carcinoma of the eyelid - the monocle tumour

APMIS. 2008 Apr;116(4):326-32. doi: 10.1111/j.1600-0463.2008.00880.x.

Abstract

We report the clinical and histopathological characteristics of two cases of signet ring cell carcinoma of the eye lids, and discuss the histogenesis of this neoplasm. Two 72-year-old Caucasian males both presented with slowly growing tumours of the eyelids. The tumours were excised and specimens were examined using light- and transmission electron microscopic techniques. Clinically, the tumours infiltrated both eyelids on one side of the face with swelling and periocular inflammation, creating a monocle-like appearance. Extensive clinical work-up excluded periocular metastases. Histopathologically, the tumours were composed of rather bland cells with mainly histiocytoid morphology. A minor proportion had a signet ring cell appearance. The cytoplasmic inclusions giving the signet ring morphology were PAS- and colloidal iron positive. The tumour cells reacted with antibodies against cytokeratins, carcinoembryonic antigen, epithelial membrane antigen, gross cystic disease fluid protein-15 and lysozyme. Transmission electron microscopy demonstrated tumour cells containing intracytoplasmic vacuoles lined by microvilli. The tumour cells aggregated in duct-like clusters. A diagnosis of primary signet ring cell carcinoma was made in both cases. Histopathological, immunohistological and ultrastructural findings indicated that the tumours were of sweat gland origin.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aminosalicylic Acid / metabolism
  • Carcinoembryonic Antigen / metabolism
  • Carcinoma, Signet Ring Cell / metabolism*
  • Carcinoma, Signet Ring Cell / pathology*
  • Carrier Proteins / metabolism
  • Eyelid Neoplasms / metabolism*
  • Eyelid Neoplasms / pathology*
  • Glycoproteins / metabolism
  • Histocytochemistry
  • Humans
  • Immunohistochemistry
  • Intranuclear Inclusion Bodies / pathology
  • Intranuclear Inclusion Bodies / ultrastructure
  • Iron Compounds / metabolism
  • Keratins / metabolism
  • Male
  • Membrane Transport Proteins
  • Microvilli / ultrastructure
  • Mucin-1 / metabolism
  • Muramidase / metabolism
  • Sweat Gland Neoplasms / metabolism*
  • Sweat Gland Neoplasms / pathology*

Substances

  • Carcinoembryonic Antigen
  • Carrier Proteins
  • Glycoproteins
  • Iron Compounds
  • Membrane Transport Proteins
  • Mucin-1
  • PIP protein, human
  • Aminosalicylic Acid
  • Keratins
  • Muramidase