A 70-year-old male noticed a swelling near the the left canthus since one-and-a-half years. The swelling was gradually increasing in size. On examination, a raised, freely mobile, firm skin mass of approximately 3.0 × 2.5 cm was present on the lateral canthal region on the left eye . The patient's extraocular eye movements were unaffected. Examination revealed no other suspicious skin lesions or palpable lymph nodes. The case was clinically diagnosed as fibroma. Excision biopsy was done and the specimen was sent for histopathological examination. Gross examination revealed a well-circumscribed, spherical soft tissue mass, partially skin covered, measuring 2 cm in diameter. The cut surface of the tumor had a gray-brown gelatinous appearance []. Microscopically, the sections revealed a tumor in the dermis composed of tumor cells arranged in nests, glands, and cribriform patterns []. The individual tumor cells were columnar and had a hyperchromatic nucleus. The cells were seen floating in large pools of mucin separated by thin fibrovascular septa []. The mucin was periodic acid schiff (PAS) positive and diastase-resistant. [] Further investigations, including a colonoscopy, ultrasonographic examination of the abdomen, and computerized tomography (CT) scans of the chest, abdomen, and pelvis were found to be normal. Thus, the lesion in the skin was reported to be PMC of the skin.
An 82-year-old male consulted MDACC with a right infraorbital ulcerated subcutaneous nodule and a right nontender neck mass. He had history of SRCC arising in the right orbit diagnosed 13 years prior to presentation at MDACC, followed by radiation therapy, chemotherapy, and right orbital exenteration. His family history revealed lung cancer in one brother, and one sister died of stomach cancer. A CT scan of the maxillofacial area and neck confirmed soft tissue thickening along the right infraorbital region () and metastases to the right intraparotid and right level II lymph nodes. A CT scan of the chest, abdomen, and pelvis showed no evidence of possible second primary disease or metastases. Revision of the right orbital exenteration, parotidectomy, and right neck dissection were performed, and positive resection margins were identified by intraoperative frozen section analysis. The indurated mass involving periorbital tissue and right upper cheek measured 5.3 × 4.5 cm. Microscopically, multifocal cords of signet ring cells arising in close proximity to eccrine dermal ducts were observed (), extending into soft tissue and surgical margins of resection. The patient underwent chemoradiation and passed away 5 years after the final treatment (18 years from initial presentation). The case was previously reported by Requena et al. [].