DISCUSSION
This is a typical presentation of an apocrine hidrocystoma (AH), a benign lesion of uncertain etiology. The eyelid is rich in apocrine, eccrine, and sebaceous glands, all of which can transform into cysts via traumatic plugging.
AH is also known as cystadenoma, Moll gland cyst, or sudoriferous cyst. It is an entity distinct from chalazions (a granulomatous reaction to sebaceous glands in the eyelid) and lacrimal duct cysts. The differential includes basal cell carcinoma, intradermal nevus, and eccrine cyst.
In my experience, merely incising and draining the cyst is useless in the long run; while this does reduce swelling, it also invites recurrence. Therefore, removal by saucerization and cauterization of the base is the best treatment option.
TAKE-HOME LEARNING POINTS
- Apocrine hidrocystomas (AHs) are benign cysts derived from plugged apocrine sweat glands, which are found in numerous areas around the body, including the eyes.
- AHs are also known as cystadenomas, Moll gland cysts, or sudoriferous cysts.
- Though AHs are often found near the eye, they are not technically an eye problem—but they do have potential to obstruct the visual field.
- Removal is usually by saucerization, with cautery of the base for hemostasis and prevention of recurrence.