To report the presentation and outcome of primary mucinous carcinoma affecting the eyelid, a low-grade malignant tumour arising preferentially on the head and neck, with historically high rate of recurrence (40%) but low metastatic potential

Retrospective case series of 9 patients diagnosed with mucinous carcinoma at Moorfields Eye Hospital between 1997-2017. 6 patients were identified with primary mucinous carcinoma of the eyelid and 1 brow. 2 patients were excluded: 1 lacrimal sac tumour & 1 ovarian metastasis. 4 underwent simple excision but recurred (100%); 3 of these underwent further simple excision, 1 underwent Mohs micrographic surgery (MMS). 2 patients had MMS initially with no recurrence

Mean age 64 (range 45-89), 3F, 4M. Ethnicity was disparate; 4 Indian, 2 black and 1 Caucasian. Similarities included tumour size >1cm and a 1-2 year history of an eyelid/brow lesion. Full body PET and MRI were performed to exclude metastatic disease. Mammography, gastrointestinal endoscopy, ultrasound and lymph node FNA in selected cases confirmed primary status. Tumour cells were positive for cytokeratin 7, oestrogen receptor (ER), progesterone receptor (PR) and Alcian blue (mucous stain)

Primary mucinous carcinoma is a rare sweat gland tumour with a predilection for the eyelid and runs an indolent course. Simple excision is associated with a high recurrence rate, 57% in this series, therefore MMS is recommended. Metastatic mucinous adenocarcinoma from extracutaneous organs should be excluded, in particular metastatic breast cancer in light of the ER/PR status