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ARTICLE
Year : 1967  |  Volume : 15  |  Issue : 2  |  Page : 73-74

Meibomian carcinoma


Dept. of Pathology, Medical College, Calicut, India

Date of Web Publication18-Jan-2008

Correspondence Address:
M Kannan Kutty
Dept. of Pathology, Medical College, Calicut
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Kutty M K. Meibomian carcinoma. Indian J Ophthalmol 1967;15:73-4

How to cite this URL:
Kutty M K. Meibomian carcinoma. Indian J Ophthalmol [serial online] 1967 [cited 2020 Jul 10];15:73-4. Available from: http://www.ijo.in/text.asp?1967/15/2/73/38686

Carcinoma of the Meibomian gland is rare. However, occasional case re計orts about the same have appeared in literature, mostly in Western literature. Accumulated literature reveals over a hundred cases (Murrah 1951: Kennedy and King 1954: Hartz 1955: Straatsma 1956).

The purpose of this paper is to pre貞ent a case of Meibomian carcinoma which incidentally is the second case we met with in our study for the past five years at the Medical College Hos計ital, Calicut.


  Pathology Top


Meibomian gland tumours, be they benign or malignant are very rare. Till recently opinion on classification of Meibomian tumours into adenoma and carcinoma was divided (Straatsma, 1956). However, certain distinct differ苟nces both in clinical aspects and histo衍ogical features have helped establish unanimity on the existence of distinct adenoma and its malignant counter計art. Meibomian carcinoma is com計osed of neoplastic cells which vary in size and shape. These cells contain fat and hence appear frothy and bubbling (Boniuk 1964). Nuclear atypia is also a feature to be reckoned with. There is no uniformity of arrangement of cells although there may be areas with at負empted glandular pattern while in others the cells may be aggregated in groups and cords. Occasional presence of vacuolated cells in basal cell car苞inoma or epidermoid carcinoma is by no means uncommon. This however does not justify the inclusion of these tumours under Meibomian carcinoma.


  Clinical Aspects Top


Clinically the condition manifests it貞elf as a painless nodule which may be firm in consistency while at times may be cystic, probably because of degene訃ation and necrosis. The cystic change might simulate clinical appearance of a sebaceous cyst. It usually occurs more commonly in the upper than the lower lid. Extension of the tumour backwards and involvement of cornea with resultant symblepharon is an ex計ected sequel. Sometimes the tumour may extend to involve the whole orbit. The spread of tumour is commonly by way of lymphatics and it is of inter苟st that patients may be presenting themselves for the first time after re苞rional lymph node involvement has occurred. It is the preauricular lymph nodes which are commonly the seat of metastasis, although less commonly submaxillary and submandibulbar may also be involved. Blood-spread with multiple metastasis may also occur.


  Case Report Top


A Muslim male aged 45 years came to the out-patients section of the Oph負halmic Department, Medical College Hospital, Calicut, on 2-7-1964. His complaint was a swelling in the lower lid of his left eye and slight watering from that eye since 5 months. He had noticed this swelling was increasing in size since a month. Previous history reveals that he had a similar swelling at the same site and that was removed two years ago. He could not, however, help us with the diagnosis of the swell虹ng that was removed then. He was ad衫itted on 4-7-1964. Examination of the swelling-It was of the size of about 1.5 cm in diameter. The skin over the surface did not show any redness or sign of inflammation. The surface was nodular and the consistency was hard. The lid was adherent to the conjunc負iva at the site of the tumour. There was trichiasis. Fundus examination normal. The swelling was excised and sent for histo-pathologist's opinion. Histopathology - Meibomian Carci要oma.


  Comments Top


To the author's knowledge, this is the second report of Meibomian Carci要oma from Kerala. Though the tumour is rare, it is felt that its occurrence may be increasingly recognised if all cases of chalazion in persons over the age of 40 years are as a routine subjected to histopathological examination.

Apart from being a rare tumour, the interesting feature of this case is the recurrence at the site of operation after a lapse of two years. History as regards the exact nature of the swelling ex苞ised two years ago is lacking. It may, however, be conjectured that the origi要al swelling was probably a chalazion, which it need hardly be said, can cli要ically simulate Meibomian carcinoma. It has already been stressed that recurrence in a chalazion particularly in the elderly should alert the surgeon to the awareness of this condition (Subramaniam et al, 1964).

The important diagnostic histologic feature is the presence of cells con負aining frothy and bubbling cytoplasm. In this case this was very evident and justifies the diagnosis of Meibomian carcinoma (Microphotograph 1). This tumour is not infrequently misinter計reted as squamous carcinoma (Boniuk, 1964). Differentiation, however, be負ween these two carcinomas is of little significance since both have potentiality to metastasise to regional lymph nodes and distant organs.


  Summary Top


A rare case of Meibomian Carcino衫a is reported, stressing the import苔nce of the presence of cells containing frothy or bubbling cytoplasm. The im計ortance of subjecting all chalazia seen in persons over 40 years to routine histopathological examination is em計hasised. A brief review of literature is also appended.


  Acknowledgement Top


The author thanks Dr. K. S. Subra衫aniam, Professor of Ophthalmology for providing the case history and Mr. Rajan for the microphotograph.[5]

 
  References Top

1.
Boniuk M. (1964), Ocular and Adnexal Tumours 87 & 88. The, C. V. Mosby Co., St. Louis.  Back to cited text no. 1
    
2.
Hartz P. N. (1955), Am. J. Clin. Path. 25, 636-41.  Back to cited text no. 2
    
3.
Kennedy R. J. and King R. W. (1954), Am. J. Ophth. 37, 250.  Back to cited text no. 3
    
4.
Murrah W. F. (1951). Am. J. Ophth., 34, 633-34.  Back to cited text no. 4
    
5.
Straatsma B. R. (1956), Arch. Oph. 56, 71-90.  Back to cited text no. 5
    


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  In this article
Pathology
Clinical Aspects
Case Report
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Summary
Acknowledgement
References
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