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Last Month’s Blink

Apocrine Hidrocystoma

Written by Mike Rosco, MD, and Rona Z. Silkiss, MD, FACS, California Pacific Medical Center, San Francisco. Photo by Rona Z. Silkiss, MD, FACS.

A 23-year-old woman presented with a 10-month history of an enlarging mass on her left eye. Slit-lamp exam revealed a well-circumscribed 1- × 1.2-cm spherical cyst of the left superotemporal bulbar conjunctiva upon inferomedial gaze (Fig. 1). The patient requested removal of the lesion as it was irritating, cos­metically distracting, and leading to an obvious fullness of the upper eyelid (Fig. 2). Surgical exci­sion was performed with narrow margins. Biopsy revealed an apocrine cell-lined cystic structure representing an apocrine hidrocystoma (Fig. 3).

Apocrine hidrocystomas are benign, well-de­fined, dome-shaped, cystic nodules with a smooth exterior. They are characterized by a double epithelial lining and an outer myoepithelial layer. Ocular apocrine hidrocystomas originate from the blocked excretion of the glands of Moll. Al­though usually found on the lid margin, apocrine hidrocystoma located on the conjunctiva has been documented in a few cases.

Predominantly seen in adults between the ages of 30 and 70, these formations are equally prev­alent in men and women, and there is no ethnic preponderance.¹

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1 Boyun K, Nam K. Int J Ophthalmol. 2012;5(2):247-248.

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