J Korean Ophthalmol Soc.  2015 Jan;56(1):109-113. 10.3341/jkos.2015.56.1.109.

A Case of Intratarsal Keratinous Cyst of the Meibomian Gland

• Choi KJ
• Kwon MJ
• Lee MJ

• KMID: 2216162
• DOI: http://doi.org/10.3341/jkos.2015.56.1.109

Abstract

PURPOSE
To report a patient presenting with an intratarsal keratinous cyst of the Meibomian gland in the upper eyelid and a review of the relevant literature.
CASE SUMMARY
A 65-year-old male presented with a right upper eyelid mass which started 5 months prior. The patient reported that the mass recurred several weeks prior even after incision and curettage procedure. The mass was 9 x 5 mm in size and located in the center of the right upper eyelid at the level of lid crease, fixed to the tarsus and a whitish elevated focus was observed at the palpebral conjunctival surface. The mass was excised under local anesthesia and originated from the tarsus. The histopathological examinations revealed an intratarsal keratinous cyst composed of stratified squamous epithelium without keratohyalin granules and filled with keratin. The immunohistochemical studies showed positive staining results for cytokeratin 5/6, epithelial membrane antigen, and carcinoembryonic antigen.
CONCLUSIONS
Intratarsal keratinous cyst of the Meibomian gland should be considered as a differential diagnosis of a recurrent tarsal mass.

Keyword

Chalazion; Epidermal cyst; Intratarsal keratinous cyst; Meibomian gland; Tarsus

MeSH Terms

Aged
Anesthesia, Local
Ankle
Carcinoembryonic Antigen
Chalazion
Curettage
Diagnosis, Differential
Epidermal Cyst
Epithelium
Eyelids
Humans
Keratins
Male
Meibomian Glands*
Mucin-1
Carcinoembryonic Antigen
Keratins
Mucin-1

Figure

• 

  Figure 1. (A) Gross appearance of a mass in the right upper eyelid. The mass was nodular, 9 × 5 mm in size, and fixed to the tarsus, whereas the overlying skin was freely movable. (B) On eversion of the upper eyelid, the tarsal portion of the mass was visible as a slightly elevated and whitish lesion.

• 

  Figure 2. Histopathological findings of the mass. (A) The cyst was lined with stratified squamous epithelium (H&E, magnification ×100). (B) The squamous epithelium of the cystic wall lacks a keratohyalin granular layer. The cystic lumen was filled with keratin strands (H&E, magnification ×400).

• 

  Figure 3. (A) Theimmunohistochemical result showed strong positivity for cytokeratin 5/6 (CK-5/6) in the basal and suprabasal layers of the squamous epithelial lining and the luminal keratin strands. (B) Immunoreaction of CK-7 was negative in the cystic wall and keratin. (C) Epithelial membrane antigen is positive in the apical layer of cystic wall and keratin strands, whereas (D) carci-noembryonic antigen is more intensely positive in these regions (magnification ×200).

Reference

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