Hidradenoma Papilliferum of the Upper Eyelid Arising from the Apocrine Gland of Moll

Hidradenoma papilliferum is derived from apocrine sweat glands and was originally described as a tumor located in the anogenital area. The authors recently examined a 78-year-old man with a hidradenoma papilliferum at the margin of the upper eyelid. While the tumor was located in the dermis, serial sections showed a connection to the epidermis and neoplastic cells partially replacing a gland of Moll. There were glandular structures with luminal cells that showed apical decapitation-type secretion, indicating the apocrine origin of the tumor. The luminal cells also contained granules that stained with periodic acid-Schiff (PAS) stain and were diastase resistant. Results of examination of the duct-forming cells by transmission electron microscopy showed adluminal villi, focal decapitation secretion, luminal cytoplasmic debris, and electron-dense cytoplasmic secretory granules. Because the apocrine glands of Moll are localized adjacent to the eyelid cilia, hidradenoma papilliferum and other tumors of apocrine origin should be considered in the clinical setting of a mass at the eyelid margin.