Purpose: To describe and summarize the clinical and histopathologic features, surgical outcome of intratarsal keratinous cyst.
Methods: The clinical findings, histopathologic evaluations, and immunohistochemical studies of 15 intratarsal keratinous cyst cases were reviewed retrospectively.
Results: Fifteen patients with an average age of 44.7 years had noninflamed eyelid nodules varied from 1 mmto6 mmin diameter, which revealed solid, whitish-opalescent or yellowish-white, mildly elevated lesions beneath the palpebral conjunctiva. Exploration via the palpebral conjunctival crease approach revealed cysts embedded in the tarsus, and cysts were completely excised with a portion of the tarsus. Histopathologic evaluations revealed stratified squamous epithelium linings and keratin contents, which were not identical to the common epidermal or epidermoid cyst. The results were negative for alcian blue and periodic acid-Schiff staining and showed positive correlation to the immunoreaction for epithelia membrane antigen. No recurrence has occurred on all patients which removed the lesion completely.
Conclusions: The characteristics of intratarsal keratinous cyst included that absence of inflammatory signs on the eyelid skin and palpebral conjunctiva, lesion partially embedded in the tarsus and protruding beneath the conjunctiva, stratified squamous epithelium linings, string -like keratin contents from the histopathology sections, and antibodies against epithelia membrane antigen strongly immunoreacted with the intracystic keratinous contents. A complete excision of cyst with partial tarsectomy by transconjunctival approach seems to be an effective treatment for prevention of recurrence. |
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