A Case of Intratarsal Keratinous Cyst of the Meibomian Gland

Kyung Jun Choi; Mi Jung Kwon; Min Joung Lee

doi:10.3341/jkos.2015.56.1.109

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Choi, Kwon, and Lee: A Case of Intratarsal Keratinous Cyst of the Meibomian Gland

Original Article

J Korean Ophthalmol Soc 2015;56(1):109-113.

Published online: 6 September 2015

DOI: https://doi.org/10.3341/jkos.2015.56.1.109

A Case of Intratarsal Keratinous Cyst of the Meibomian Gland

Kyung Jun Choi, MD¹, Mi Jung Kwon, MD², Min Joung Lee, MD^1,

¹Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea

²Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea

Address reprint requests to Min Joung Lee, MD, Department of Ophthalmology, Hallym University Sacred Heart Hospital, #22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 431-796, Korea, Tel: 82-31-380-3834, Fax: 82-31-380-3833 E-mail: tweeti2@hanmail.net

Received 5 July 201416 August 2014 Accepted 2 December 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 kera-tohyalin 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.

Keywords: Chalazion, Epidermal cyst, Intratarsal keratinous cyst, Meibomian gland, Tarsus

References

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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).

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