|Year : 2015 | Volume
| Issue : 1 | Page : 84-85
Pleomorphic adenoma of the eyelid: A case report
Gurudutt M Kamath1, Madhurima K Nayak1, Ramadas Naik2
1 Department of Ophthalmology, Kasturba Medical College, Mangalore, Karnataka, India
2 Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India
|Date of Web Publication||8-Dec-2014|
Gurudutt M Kamath
C II 12, KMC Staff Quarters, Light House Hill Road, Mangalore - 575 003, Karanataka
Source of Support: None, Conflict of Interest: None
Chondroid syringoma or pleomorphic adenoma of the skin is a rare tumor arising from the eccrine glands. It is an asymptomatic slow growing tumor. We report a case of chondroid syringoma of the lower eyelid margin and lateral canthus in a middle-aged man, which was excised. The lid was reconstructed by lateral cantholysis and advancement flap for lid reconstruction. A possible diagnosis of chondroid syringoma should be borne in mind when solitary, firm tumors of the lid are presented.
Keywords: Chondroid syringoma, eyelid tumor, pleomorphic adenoma of the skin
|How to cite this article:|
Kamath GM, Nayak MK, Naik R. Pleomorphic adenoma of the eyelid: A case report. Muller J Med Sci Res 2015;6:84-5
| Introduction|| |
Chondroid syringoma represents the cutaneous form of pleomorphic adenoma of the skin, and hence, is sometimes referred to as a mixed tumor of the skin. It is a rare tumor with a predilection for the head and neck area. It arises from the eccrine glands and can affect the eyelids also. It accounts for 0.48% of the lid tumors.  The tumor has an epithelial origin, with secondary changes in the stroma. As per Gunduz et al., only 26 cases of chondroid syringoma in the periorbital area have been reported up to 2006. 
| Case Report|| |
A 38-year-old male presented with a painless mass in the lateral part of the right lower lid since around a year [Figure 1]. He had a similar lesion at the same site, which was excised two years back. On examination, vision was 20/20, N6 in both eyes. The lower lid margin of the right eye showed a firm mass of size 1 cm × 1 cm × 0.5 cm involving the lateral canthus. The surface was irregular. The skin overlying the mass could not be pinched. There was no discoloration of the surface. The conjunctiva was also involved. The extraocular movements were normal and full. The fundus was normal. The systemic examination was normal. He underwent excision of the mass, with lateral canthotomy and advancement flap, for lid reconstruction. The cut section of the tumor was pale white. Histopathology of the mass showed that the skin had a circumscribed tumor in the dermis [Figure 2]. The tumor consisted of glandular structures lined by a two-layered epithelium, with varied cystic dilatation. These glands, surrounded by abundant basophilic chondroid-like stroma [Figure 3] and [Figure 4], were suggestive of chondroid syringoma. He was followed up for six months and no recurrences were observed.
|Figure 4: Cystic dilatations with surrounding basophilic chondromyxoid stroma|
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| Discussion|| |
Chondroid syringoma or pleomorphic adenomas are of apocrine or eccrine origin. It usually presents as a painless mass, usually firm, but cystic variants have been reported. 
The histopathology of the tumor resembles pleomorphic adenoma of the salivary gland and the lacrimal gland. The glandular structures, with a two-layered epithelium, show various cystic dilatations, with surrounding basophilic stroma. The outer layer of cells is thought to produce the chondroid stroma. 
Treatment of the tumor is excision with lid reconstruction. Lid reconstruction following the resection of tumor depends upon the site and size of the tissue lost. In this case, excision was followed by lateral cantholysis and advancement of the lid, to create a direct closure. Defects smaller than 25% of the total horizontal dimension of the lid can be closed by direct apposition. Defects of size between 25 and 50% require a lateral cantholysis or Tenzel semicircular flap. Defects larger than 50% need a Hughes procedure, Mustarde cheek advancement flap or a Tripier or bipedicle muscle flap with chondromucosal graft. 
| References|| |
Tyagi NN, Abdi U, Tyagi SP, Maheshwari V, Gogi R. Pleomorphic adenoma of skin (chondroid syringoma) involving the eyelid. J Postgrad Med 1996;42:125-6.
Gündüz K, Demirel S, Heper AO, Günalp I. A rare case of atypical chondroid syringoma of the lower eyelid and review of the literature. Surv Ophthalmol 2006;51:280-5.
Palioura S, Jakobiec FA, Zakka FR, Iwamoto M. Pleomorphic adenoma (formerly chondroid syringoma) of the eyelid margin with a pseudocystic appearance. Surv Ophthalmol 2013;58:486-91.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4]