Hidrocystoma

EPIDEMIOLOGY

Hidrocystoma (cystadenoma) is a relatively common cystic lesion presenting mostly in middle-aged or elderly individuals.

ETIOLOGY

Hidrocystoma shows features of either apocrine (apocrine type) or eccrine (eccrine type) differentiation.

CLINICAL FINDINGS

 Hidrocystoma is a solitary, small- to medium-sized, skin-colored, reddish or bluish cystic nodule situated on the head or neck, especially in the periorbital region. Unusual presentations include multiple lesions, giant tumors (up to 7 cm), and lesions occurring in childhood. Hidrocystoma occasionally develops within a nevus sebaceus . Multiple apocrine hidrocystomas on the upper and lower eyelid margins bilaterally may be a feature of a rare variant of ectodermal dysplasia (Schopf-Schulz-Passarge syndrome).

HISTOPATHOLOGY

On histologic examination, there is a unilocular or occasionally a multilocular cyst located in the dermis. The epithelial lining displays either features of apocrine (decapitation secretion) or eccrine (single or double layered, cuboid often flattened epithelium) differentiation. Prominent papillations protruding into the lumen are noted in a subset of cases . Secretory products contain lipofuscin, melanin, and/or hemosiderin.

TREATMENT

Treatment of choice in solitary lesions is simple surgical excision. Multiple lesions may be removed using a carbon dioxide or nonablative diode laser, electrodesiccation, local infiltration of trichloroacetic acid, or surgery with blepharoplasty.