Clinicopathological Features and Surgical Treatment of Intratarsal Keratinous Cysts

Abstract

Our study revealed the clinical and pathological characteristics of IKC, including the absence of inflammatory sign, lesion partially embedded in the tarsus and protruding beneath the conjunctiva with the intracystic keratinous contents, stratified squamous epithelium linings, string-like keratin contents from the histopathology sections, and strongly immunoreactivity to antibodies against epithelial membrane antigen. A complete excision of cysts with adjacent tarsectomy by transconjunctival approach was proved to be an effective treatment for prevention of recurrence.

A longstanding cystic swelling of the upper eyelid

“…Complete excision of the cyst is recommended, as incomplete excision appears to lead to further local disease. It is difficult to excise the cyst from the tarsal plate, and other authors have either performed a wedge excision of the lid or excised the cyst with the tarsal plate in situ at the base of the cyst (partial tarsectomy) 12. The importance of aggressive and effective primary surgery lies in the fact that some recurrences reported in the literature have required more complex lid reconstructions 7.…”

A grey keratinous tarsal cyst with Gram+ cocci

“…; Zhang et al. ). Some lesions originally reported as epidermal inclusion cysts, epidermoid cysts and steatocystoma simplex were recently also considered to be consistent with the diagnosis of an intratarsal keratinous cyst of Meibomian gland origin (Jakobiec et al.…”

“…They were designated intratarsal keratinous cysts. Twenty-one additional patients have been reported later including one patient with multiple cysts and one with spontaneous extrusion of cyst contents (Patel et al 2011;Kim et al 2012;Rajaii et al 2013;Zhang et al 2013). Some lesions originally reported as epidermal inclusion cysts, epidermoid cysts and steatocystoma simplex were recently also considered to be consistent with the diagnosis of an intratarsal keratinous cyst of Meibomian gland origin (Jakobiec et al 2010;Patel et al 2011), which possibly is the third most common but currently underdiagnosed benign tarsal tumour.…”

Sebaceous gland carcinoma of tarsus can be misdiagnosed as intratarsal keratinous cyst

“…No adnexae, such as sebaceous lobules or follicles, are attached to the cyst. 3,4 By immunohistochemical staining, the inner lining of IKC reveals distinct expressions of carcinoembryonic antigen and epithelial membrane antigen such as cytokeratin 17. SGC is composed of irregular lobular masses with signs of invasion.…”