A Rare Benign Tumor of the Eyelid: Clinical and Pathological Insights
An 81-year-old man presented with a slowly enlarging, yellowish-pink papillomatous growth on the lower eyelid of his left eye. The lesion had gradually increased in size over several years, prompting a thorough diagnostic evaluation.
Diagnosis: Sebaceous Adenoma
Histopathological examination revealed well-circumscribed lobules of mature sebocytes with vacuolated cytoplasm, surrounded by a peripheral layer of basaloid cells. No nuclear atypia, necrosis, or significant mitotic activity was observed, confirming the benign nature of the lesion.
Immunohistochemistry Findings
Positive staining for epithelial membrane antigen (EMA) confirmed sebaceous differentiation. The Ki-67 proliferative index was low, at less than 5%, further supporting the diagnosis of a benign tumor.
Differential Diagnosis
The lesion's unusual papillomatous appearance initially raised concern for other eyelid lesions, particularly sebaceous carcinoma, a malignant tumor. Accurate differentiation between benign sebaceous adenoma and malignant sebaceous carcinoma is critical for appropriate management.
Associated Conditions
The authors note a potential association with Muir–Torre syndrome, a hereditary cancer predisposition syndrome. However, the patient had no personal or family history suggestive of this condition.
"The report emphasizes the importance of combining clinical examination, histopathology, and immunohistochemistry to accurately diagnose rare eyelid lesions."
Conclusion
This case highlights the need for careful diagnostic workup when encountering rare eyelid tumors. Combining clinical examination, histopathology, and immunohistochemistry is essential to distinguish benign sebaceous adenoma from malignant sebaceous carcinoma. The patient's lack of personal or family history for Muir–Torre syndrome suggests this was an isolated finding, but awareness of the association remains important for clinicians.
Published in Oncoscience, Volume 13, April 2, 2026
Study conducted by Gunvanti Rathod (first and corresponding author), Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), India