case_images: PMC8601830_01
case_images: Case 1: (a) CT of maxillofacial area disclosing enhancement along the right infraorbital region (arrow); (b) multifocal cords of signet ring cells infiltrating dermis and directly associated with eccrine dermal ducts (H&E 10x). Inset disclosing single dyshesive signet ring cells infiltrating connective tissue (H&E 20x). Case 2: (c) MRI of the orbit, face, and neck depicting a right anterior mass adjacent to the nasolacrimal duct (arrow); (d) neoplastic cells infiltrating connective tissue and disclosing perineural invasion (inset: 20x).
case_images: CRIPA2021-6628150.002.jpg
case_images: PMC8601830_02_CRIPA2021-6628150.002.jpg
case_images: fig2
case_images: An MRI of the orbit, face, and neck performed at MDACC demonstrated a thickened enhancing lesion adjacent to the right nasolacrimal duct measuring 4.1 x 1.0 cm (Figure 2(c)) which extends from the medial canthus to the lateral inferior periorbital soft tissue. Microscopically, cords of histiocytoid cells arising from eccrine glands were identified infiltrating skeletal muscle and orbit with extensive perineural invasion (Figure 2(d)).
case_images: PMC8601830_02
case_images: Case 1: (a) CT of maxillofacial area disclosing enhancement along the right infraorbital region (arrow); (b) multifocal cords of signet ring cells infiltrating dermis and directly associated with eccrine dermal ducts (H&E 10x). Inset disclosing single dyshesive signet ring cells infiltrating connective tissue (H&E 20x). Case 2: (c) MRI of the orbit, face, and neck depicting a right anterior mass adjacent to the nasolacrimal duct (arrow); (d) neoplastic cells infiltrating connective tissue and disclosing perineural invasion (inset: 20x).
case_images: CRIPA2021-6628150.002.jpg
case_images: PMC8601830_02_CRIPA2021-6628150.002.jpg
case_images: fig2
case_images: An MRI of the orbit, face, and neck performed at MDACC demonstrated a thickened enhancing lesion adjacent to the right nasolacrimal duct measuring 4.1 x 1.0 cm (Figure 2(c)) which extends from the medial canthus to the lateral inferior periorbital soft tissue. Microscopically, cords of histiocytoid cells arising from eccrine glands were identified infiltrating skeletal muscle and orbit with extensive perineural invasion (Figure 2(d)).
case_images: PMC8601830_03
case_images: Case 3: (a) MRI depicting an infiltrative lesion involving pre- and postseptal regions of the left upper and lower eyelids (arrow); (b) tarsus diffusely infiltrated by neoplastic cells (H&E 4x). Inset: higher magnification of cords of neoplastic cells infiltrating skeletal muscle (20x). Case 4: (c) CT scan shows enhancing and infiltrative mass along the inferomedial aspect of the left anterior orbit; (d) panoramic view shows neoplastic cells forming a mass lesion adjacent to the punctum (arrowhead) and infiltrating caruncle (H&E). Inset: higher magnification depicting tumor cells with vesicular nuclei, large nucleoli, and eosinophilic cytoplasm with intracytoplasmic vacuolization (H&E 20x).
case_images: CRIPA2021-6628150.003.jpg
case_images: PMC8601830_04_CRIPA2021-6628150.003.jpg
case_images: fig3
case_images: A CT scan of orbits and head and neck soft tissue demonstrated an enhancing and infiltrative mass along the inferomedial aspect of the left anterior orbit (Figure 3(c)) and no evidence of facial or cervical lymphadenopathy. Histopathologically, neoplastic cells forming a mass lesion adjacent to the punctum and infiltrating caruncle was seen (Figure 3(d)). Cords of pleomorphic cells with histiocytoid appearance infiltrating connective tissue and depicting vesicular nuclei, large nucleoli, and eosinophilic cytoplasm with intracytoplasmic vacuolization were identified (Figure 3(d) inset).
case_images: PMC8601830_04
case_images: Case 3: (a) MRI depicting an infiltrative lesion involving pre- and postseptal regions of the left upper and lower eyelids (arrow); (b) tarsus diffusely infiltrated by neoplastic cells (H&E 4x). Inset: higher magnification of cords of neoplastic cells infiltrating skeletal muscle (20x). Case 4: (c) CT scan shows enhancing and infiltrative mass along the inferomedial aspect of the left anterior orbit; (d) panoramic view shows neoplastic cells forming a mass lesion adjacent to the punctum (arrowhead) and infiltrating caruncle (H&E). Inset: higher magnification depicting tumor cells with vesicular nuclei, large nucleoli, and eosinophilic cytoplasm with intracytoplasmic vacuolization (H&E 20x).
case_images: CRIPA2021-6628150.003.jpg
case_images: PMC8601830_04_CRIPA2021-6628150.003.jpg
case_images: fig3
case_images: A CT scan of orbits and head and neck soft tissue demonstrated an enhancing and infiltrative mass along the inferomedial aspect of the left anterior orbit (Figure 3(c)) and no evidence of facial or cervical lymphadenopathy. Histopathologically, neoplastic cells forming a mass lesion adjacent to the punctum and infiltrating caruncle was seen (Figure 3(d)). Cords of pleomorphic cells with histiocytoid appearance infiltrating connective tissue and depicting vesicular nuclei, large nucleoli, and eosinophilic cytoplasm with intracytoplasmic vacuolization were identified (Figure 3(d) inset).