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| ARTICLE |
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| Year : 1967 | Volume
: 15
| Issue : 2 | Page : 73-74 |
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Meibomian carcinoma
M Kannan Kutty
Dept. of Pathology, Medical College, Calicut, India
| Date of Web Publication | 18-Jan-2008 |
Correspondence Address:
M Kannan Kutty
Dept. of Pathology, Medical College, Calicut
India
 Source of Support: None, Conflict of Interest: None  | Check |
How to cite this article:
Kutty M K. Meibomian carcinoma. Indian J Ophthalmol 1967;15:73-4 |
Carcinoma of the Meibomian gland is rare. However, occasional case reports 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 present 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 Hospital, Calicut.
| Pathology | |  |
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 differences both in clinical aspects and histological features have helped establish unanimity on the existence of distinct adenoma and its malignant counterpart. Meibomian carcinoma is composed 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 attempted glandular pattern while in others the cells may be aggregated in groups and cords. Occasional presence of vacuolated cells in basal cell carcinoma or epidermoid carcinoma is by no means uncommon. This however does not justify the inclusion of these tumours under Meibomian carcinoma.
| Clinical Aspects | | |
Clinically the condition manifests itself as a painless nodule which may be firm in consistency while at times may be cystic, probably because of degeneration 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 expected 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 interest that patients may be presenting themselves for the first time after recrional 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 | | |
A Muslim male aged 45 years came to the out-patients section of the Ophthalmic 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 swelling that was removed then. He was admitted 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 conjunctiva 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 Carcinoma.
| Comments | | |
To the author's knowledge, this is the second report of Meibomian Carcinoma 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 excised two years ago is lacking. It may, however, be conjectured that the original swelling was probably a chalazion, which it need hardly be said, can clinically 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 containing 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 misinterpreted as squamous carcinoma (Boniuk, 1964). Differentiation, however, between these two carcinomas is of little significance since both have potentiality to metastasise to regional lymph nodes and distant organs.
| Summary | | |
A rare case of Meibomian Carcinoma is reported, stressing the importance of the presence of cells containing frothy or bubbling cytoplasm. The importance of subjecting all chalazia seen in persons over 40 years to routine histopathological examination is emphasised. A brief review of literature is also appended.
| Acknowledgement | | |
The author thanks Dr. K. S. Subramaniam, Professor of Ophthalmology for providing the case history and Mr. Rajan for the microphotograph.[5]
| References | | |
| 1. | Boniuk M. (1964), Ocular and Adnexal Tumours 87 & 88. The, C. V. Mosby Co., St. Louis.  |
| 2. | Hartz P. N. (1955), Am. J. Clin. Path. 25, 636-41. |
| 3. | Kennedy R. J. and King R. W. (1954), Am. J. Ophth. 37, 250. |
| 4. | Murrah W. F. (1951). Am. J. Ophth., 34, 633-34. |
| 5. | Straatsma B. R. (1956), Arch. Oph. 56, 71-90. |
[Figure - 1]
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