Endocrine mucin-producing sweat gland carcinoma

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare, low-grade, cutaneous neoplasm that may be associated with invasive mucinous carcinoma. Tumors typically present as slow-growing, flesh-colored, nonspecific papules or nodules that favor the eyelids in older individuals. Histologic examination usually reveals basaloid nodules composed of cells with eosinophilic cytoplasm, with focal mucin production and occasional glandular structures. Definitive diagnosis requires immunohistochemical staining. Endocrine mucin-producing sweat gland carcinomas have been noted to stain positively with neuroendocrine markers such as synaptophysin and chromogranins as well as cytokeratin 7, cytokeratin CAM 5.2, epithelial membrane antigen, estrogen receptor, and progesterone receptor. Complete excision with close follow-up is important given EMPSGC's association with invasive mucinous carcinoma. Mohs micrographic surgery is an appropriate choice for treatment. We report 2 cases of EMPSGC presenting on the eyelids in a 72-year-old woman and a 74-year-old man.