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Complex Intratarsal Cyst with a Mixed Ciliated Respiratory-Type and Squamous Epithelial Lining
Frederick A Jakobiec1, Paula Cortes Barrantes1, Lina Ma1
1David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary/Harvard Medical School, Boston, Massachusetts, USA.
Ocular Oncology and Pathology
|June 9, 2020
Summary
A rare congenital eyelid cyst, likely from embryonic tissue, was successfully removed from a 55-year-old woman. This painless swelling highlights the persistence of developmental epithelial remnants.
Area of Science:
- Ophthalmology
- Dermatology
- Pathology
Background:
- Eyelid masses can present with varied etiologies.
- Congenital lesions of the eyelid are uncommon in adults.
Observation:
- A 55-year-old woman presented with a 6-month history of painless, non-ulcerated left upper eyelid swelling.
- Examination revealed a fluctuant mass with mobile overlying skin.
- Surgical resection exposed a well-encapsulated cyst within the tarsus.
Findings:
- Histopathology showed a cyst lined by ciliated respiratory-type and non-keratinizing squamous epithelia.
- Immunohistochemistry (cytokeratins 17, 18, 19) confirmed respiratory epithelial cell staining.
- The cyst is interpreted as a congenital remnant of embryonic ciliated glandular epithelium.
Implications:
- This case suggests a congenital origin for certain eyelid cysts due to persistent embryonic tissues.
- Ectopic epithelial cells from adjacent sinuses are a less likely differential diagnosis.
- Successful surgical excision without recurrence indicates a favorable prognosis for this type of lesion.
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