Adenoid cystic carcinoma arising from the lower eyelid

Background: Primary cutaneous adenoid cystic carcinoma is one of the rarest eyelid tumors. Case: A 39-year-old man presented with a small subcutaneous induration in his left lower eyelid close to the lower lacrimal punctum. Observations: Under a clinical diagnosis of chalazion, the eyelid induration was extracted surgically via the palpebral conjunctiva. Histopathological examination of the extracted tumor revealed proliferation of basaloid cells with a prominent cribriform pattern containing Alcian blue-positive and periodic acid Schiff-positive material, leading to a diagnosis of adenoid cystic carcinoma. The patient subsequently underwent extended radical excision including the lacrimal sac. No recurrence was observed during 20 months after surgery. Conclusions: Adenoid cystic carcinoma should be considered as a differential diagnosis of eyelid tumors simulating chalazion. Adenoid cystic carcinoma in the eyelid may have a more favorable prognosis than that in the lacrimal gland.