Apocrine Hidrocystoma- A Histological Diagnosis

An Asian female in her 20s, presented with a painless swelling in the left upper eyelid for 2 years. A cystic, non-tender, well defined swelling of 3 by 4 mm with a punctum was seen in the medial aspect of left upper eyelid. Best corrected visual acuity was 20/20 in both eyes, with anterior and posterior segment examination within normal limits in both eyes. Provisional diagnosis of Sebaceous cyst was made, excision of cyst was planned for cosmetic indication. Cyst removal in toto was done and sent for histopathological examination. HPE report was awaited and came the surprise report - APOCRINE HIDROCYSTOMA, a rare, benign, cystic tumor of the apocrine sweat glands. Since surgical excision is the treatment option for apocrine hidrocystoma, patient was informed of the same and reassured. The diagnosis is histological and hence apocrine hidrocystoma must be kept in mind while considering differential diagnosis of cystic lesions in ocular adnexa.