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ARTICLE
Year : 1966  |  Volume : 14  |  Issue : 3  |  Page : 144-145

Adenocarcinoma of Meibomian glands -report of 2 cases


Ophthalmic Dept.. Sardar Patel Medical College, Bikaner, India

Date of Web Publication16-Jan-2008

Correspondence Address:
S D Sharma
Ophthalmic Dept.. Sardar Patel Medical College, Bikaner
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Sharma S D. Adenocarcinoma of Meibomian glands -report of 2 cases. Indian J Ophthalmol 1966;14:144-5

How to cite this URL:
Sharma S D. Adenocarcinoma of Meibomian glands -report of 2 cases. Indian J Ophthalmol [serial online] 1966 [cited 2020 Aug 7];14:144-5. Available from: http://www.ijo.in/text.asp?1966/14/3/144/38648

Carcinomata of the sebaceous glands of the skin are extremely rare. Mei­bomian glands are modified sebaceous lands. There is a lot of difference in views about the occurrence of adeno-carcinoma in Meibomian glands. Al­though such cases were reported by Allaire (1891) Panas (1894) Parsons (1904), some authors, such as V. Michel (1908) and Schreiber (1924) ex­pressed doubts as to the existence of such tumours.

The view of Morax (1926) that all Meibomian neoplasms were carcino­matous is also not absolutely correct, at least for age groups under 40 years.

Meibomian carcinoma, usually oc­curs in women, of middle age and over. It is met with in both lids. Its progress is insidious and painless. It is invari­ably mistaken for chalazion, especially if the patient happens to seek advice early. If the patient comes only when it is of a fairly big size then the doubt of a neoplasm creeps up. If there is history of recurrence, then the ques­tion of malignancy arises otherwise a routine biopsy in at least an elderly patient with a chalazion like swelling is a safe and correct approach.

When this growth is mistaken for chalazion, and is incised and curetted, the growth rapidly recurs, with in­volvement of tarsal conjunctiva and lid margins, there is spread to preauricular or other regional lymphnodes and later on, distant multiple metastases may prove fatal.


  Case No. 1 Top


A 54 year old Hindu lady, other­wise healthy, came with a swelling in the middle of right upper lid, which had started 2 years back. The swell­ing was incised in a dispensary 6 months back, but it recurred after a month. It was once again incised by the doctor of another dispensary 4 months back, after which it has been continuously increasing, to reach the present size. She has also noticed a swelling one month back, in front of her right ear. On examination, it was found that the whole of the right up­per lid was involved in the tumor mass. The size of the tumor was 2½ x 1 x 1 in., the preauricular glands on right side were enlarged to the size of an almond. The diagnosis of ade­nocarcinoma of Meibomian gland was made. The patient was advised to have a complete resection of right upper lid and of the right preauricular swelling followed by a plastic repair and deep X-ray irradiation. As she was unwilling for any further surgical treatment, the two previous operations having failed, only a biopsy was taken before starting deep X-ray therapy. The histological report suggested the diagnosis of adenocarcinoma of Mei­bomian gland.

Deep X-ray therapy was started on the right upper lid, with a protective shield for the right eye and on the right preauricular region, but she left after 10 days as she did not notice any appreciable improvement in her condi­tion.

After 3 months, the patient again visited the hospital: now she had en­largement of submaxillary and clavi­cular lymph nodes. After six months or so, we learnt from her relation, that she had expired, probably from distant metastases in abdomen or mediasti­nuin.


  Case No. 2 Top


A 50 year old Hindu female, other­wise healthy, came with a swelling in the right lower lid, which had started one year back. There was rapid in­crease in the swelling for the last two months. [Figure - 1]

The present size of the growth was 2 x 1 x 1 in. in the lateral 2/3 of the right lower lid. It was firm in con­sistency and was not tender. The right preauricular gland was enlarged and firm in consistency.


  Treatment Top


The growth was removed, with re­section of nearly ¾ of right lower lid and of the lymph nodes in the pre­auricular area. Later on, prophylactic deep X-ray therapy was given, after the plastic repair of the part.

The histological report was: Adeno-carcinoma of meibomian gland. [Figure - 2]. No recurrence has been reported after six months.


  Discussion Top


Adenocarcinoma of the Meibomian gland does not seem to be very rare. The incidence appears to be definitely more than is thought to be. The lack of histological survey of all chalazia, might be responsible for this very low percentage. In the cases reported here, both were females, one had it in the upper lid and the other in the lower one. Both the patients were over 50 years of age. The mode of onset was insidious and the growths were pain­less. In the first case, its quicker spread and distant metastases could be explained due to its getting irritated by insufficient surgery.


  Summary Top


Two case-reports of Meibomian carcinoma both in females and both over the age of 50 have been reported.

It is emphasised that chalazia in elderly patients or where there has been recurrence after incision and cur­retting must be invariably examined histologically to exclude malignancy.

Acknowledgements : I am thankful to Dr. B. C. Singhal, M.D. for the histo­pathological examination and for the microphotograph.[5]

 
  References Top

1.
Das S. P. (1962). J. All India Oph. Society. 10: 36-38.  Back to cited text no. 1
    
2.
Duke Elder (1952), Text-book of Oph. Vol. 5 Henry Kimpton, London, p. 5065. For Refs. Allaire (1891). Morax (1926). Panas (1894). Parsons (1904). Schreiber (1924) and V. Michel (1908).  Back to cited text no. 2
    
3.
Jain B. S. Am. J. Oph. 1964. 57: 1050-1052.   Back to cited text no. 3
    
4.
Kennedy R. J.. Am. J. Oph. (1954), 37: 250-260.  Back to cited text no. 4
    
5.
Spaeth, E. B. (1951). Archives of Oph. 46­:421-423.  Back to cited text no. 5
    


    Figures

  [Figure - 1], [Figure - 2]



 

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  In this article
Case No. 1
Case No. 2
Treatment
Discussion
Summary
References
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