Sclerosing sweat duct carcinoma of the eyelid.

Background: Sclerosing sweat duct carcinoma (SSDC) is a rare variant of sweat gland carcinomas. We report a case of SSDC of the eyelid.

Case: A 33-year-old woman presented with a painless, slowly enlarging nodule in her left lower eyelid. Incisional biopsy revealed proliferated ducts lined by two layers of epithelium embedded in a dense fibrous stroma. Cytologic atypia was not evident. Initial histopathological diagnosis was a syringoma or an inflammatory reaction.

Observations: Four years after initial biopsy, the mass had enlarged slightly. Madarosis was observed thereafter. The lesion was excised completely with frozen section evaluation of the margins and repaired by a semicircular rotation flap. Microscopically, variable sized tubular structures could be seen invading the deep dermis and muscle. The final diagnosis was SSDC.

Conclusions: This tumor is seldom recognized and is frequently confused with benign syringoma or inflammation. Wide and deep excisional biopsy is necessary for correct diagnosis and successful treatment.