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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2601 - 25 June 2020 Posted By: Saleem Taibjee

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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55F, Cyst right lower eyelid.


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Difficult, without any evidence of glandular differentiation and mucin secretion.Some salt and pepper appearance of nuclei in last picture. Favor EMPSGC.

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1 hour ago, vincenzo said:

Difficult, without any evidence of glandular differentiation and mucin secretion.Some salt and pepper appearance of nuclei in last picture. Favor EMPSGC.

Agree

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Saleem Taibjee

Posted

Here are some immunostains

12303_10.0x synaptophysin labelled.jpg

12303_20.0x Chromogranin labelled.jpg

 

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Richard Logan

Posted

The immunohistochemistry would support the suggested diagnosis of EMPSGC.

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John Zhang

Posted

Nice case. Thank you for sharing!

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Saleem Taibjee

Posted

Yes, well done, this is Endocrine mucin-producing sweat gland carcinoma. In addition to the cytological clues which Vincenzo points out, the impression of dyscohesion / 'falling apart' is helpful, as well as the characteristic location on the eyelid. As in this case, mucin and glands can be hard to identify.

This is referred to as a carcinoma, with a possibility of local recurrence, but there have been no instances of metastasis reported as far as I know.

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Krishnakumar subramanian

Posted

thanks for the interesting case Dr

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