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Endocrine Mucin-Producing Sweat Gland Carcinoma of the Eyelid With Locoregional Metastasis to the Parotid Gland.

A 71-year-old woman presented to a dermatologist with an enlargingmass on her right eyelid. The patient stated the lesion first appeared 10 years prior at which time it was surgically removed. She was unclear of the pathologic diagnosis. Upon presentation, she reported the lesion had been progressively enlarging for approximately 3 years. A biopsy performed 6 weeks prior by an outside dermatologist was read as “papillary epithelial proliferation, probable papilloma.” However, based on the patient’s history and physical examination, a nonmelanoma skin cancer was favored. She denied any associated pain or history of orbital trauma but that themass obstructed her vision. Physical examination revealed a 2.3-cm firm mass occupying the lateral two-thirds of the right upper eyelid, with extension to the bulbar conjunctiva. No satellite lesions, neurological deficits, or neck adenopathy were detected on physical examination. An incisional biopsy was performed, and a new diagnosis of endocrine mucin-producing sweat gland carcinoma (EMSPGC) was made. The patient was informed of the diagnosis of the low-grade malignancy; however, she declined surgery to remove the lesion.