PMC6487760_01
Lesion on presentation.
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It involved the lower eyelid (Figure 1).
CT imaging of the lesion at presentation.
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A computed tomography (CT) scan of the orbit revealed right anterior orbital invasion with no bony or lacrimal gland involvement (Figure 2).
Hematoxylin and eosin staining (H&E): (a) the transition between squamous and glandular epithelium (100x). (b) Large areas of superficial epithelium were sphacelated. Glandular invaginations showed a characteristic funnel shape. Papillary structures can be identified inside a dermal cyst (100x). (c) The papillary structures are lined with a stratified atypical epithelium. Micropapillae and secretion by decapitation can be seen (100x). (d) At high power magnification, atypical nuclei are evident. Large atypical nuclear shapes are seen and increased mitotic activity is observed (*).
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These cells had significant nuclear pleomorphism, prominent nucleoli, and increased mitotic activity (Figure 3). Immunohistochemical staining demonstrated positivity for epithelial membrane antigen (EMA), Cytokeratin 8/18, and a Cytokeratin cocktail of high and low density (Figure 3).