View 2019 Abstracts

We present a rare case of hidradenocarcinoma in the eyelid which developed 13 years after excision of a hidradenoma in the same location.

A 79 year old man presented with extensive recurrence of a previously excised right upper eyelid tumour. 13 years previously a hidradenoma had been excised from the same location. Incisional biopsies demonstrated features of an atypical hidradenoma; however following clinical-pathological correlation this case was managed as a hidradenocarcinoma. The lesion was treated with debulking surgery of the anterior lamella and skin graft reconstruction. Pathological examination of the excised specimen confirmed the diagnosis of hidradenocarcinoma extending to the excision margins. Further treatment of cryotherapy to the right eyelid was performed with excellent results and the patient remains well with no evidence of recurrence or metastasis.

Hidradenocarcinomas are very rare, aggressive malignant eccrine gland tumours which most commonly occur in the head and neck region. Histological differentiation from benign hidradenomas is challenging and may require clinical-pathological correlation. There is very limited literature relating to the management of these tumours in the eyelid. Our case was successfully managed with surgical excision and adjuvant cryotherapy demonstrating the utility of this approach.

This case presents challenges both in the diagnosis and management of this rare malignancy as well as highlighting the role of multi-disciplinary team working. Our experience adds to a very limited literature regarding hidradenocarcinoma of the eyelid.