Case Number : Case 2332 - 24 May 2019 Posted By: Dr. Richard Carr

what an interesting lesion! I don't know what it is. But the presence of multiple round lumen, especially in fig 3, makes me think of a sweat gland neoplasm. Also it's the eyelid, I would run neuroendocrine markers chromogranin, synaptophysin to rule out EMPSGC. If these stains are negative, I would run CEA, if the lumen is positive then I will consider hidradenoma or tubular adenoma. But because I am not sure if the periphery is infiltrative, I would recommend excision in case it is a sweat gland carcinoma. If CEA is negative, I will consider metastatic renal cell carcinoma (RCC and PAX8 to confirm).

I feel like that I am firing a shotgun towards the other direction of the target. But hey this forum is so pleasant I dare to have a chit chat...

I don't think it is sebaceous carcinoma. But would run adipophilin if the neuroendocrine markers are negative.

On picture 3 we can see better the true nature of this proliferation. I think this is a syringoma presenting a huge clear cell differentiantion in the cytoplasm (seen better in the other pictures). So, this is a clear cell syringoma.

Tricky and intriguing case! The differentiation seems follicular-trichilemmal. I see something reminiscent of trichoadenoma and something reminiscent of desmoplastic trichilemmoma. ?Mixed clear cell trichoadenoma-trichilemmoma?

looks like a benign tumor more for trichelemmoma like 

do not know

Completely agree with Igor's observation. Clear cell syringoma.

Would also agree with Igor based on site and obvious syringoma in 3rd pic.

agree, looks like clear cell syringoma

I think there are two main possibilites i.e. Syringoma, clear cells with unusually expansile solid lobules or dermal duct tumour, clear cell variant. I guess it is academic. Certainly the lack of typical poroid elements and location favour the former.

https://www.ncbi.nlm.nih.gov/pubmed/18042069

Thanks a lot sir, for interesting case to learn pattern diagnosis

agree， clear cell syringoma。

What a beautiful case!