Metastatic eyelid tumours are rare and account for less than 2% of all eyelid neoplasms. We report a case of metastatic breast carcinoma to the eyelid in a 60-year-old Chinese lady presenting with a 2-year history of enlarging, painless nodular lower eyelid swelling. The 1 cm diameter lesion was provisionally diagnosed as a sebaceous cyst. However the excision biopsy revealed a mucinous carcinoma expressing oestrogen receptor protein. She had a past history of mastectomy one year previously and histology showed an infiltrating ductal carcinoma (oestrogen receptor status negative) without evidence of axillary lymph node metastasis. She had completed adjuvant radio- and chemotherapy. Further treatment of the current lesion involved a wide excision which did not show any residual malignancy. She had no other evidence of metastasis and was treated with letrozol. We highlight this case to create awareness among clinicians and opthalmologists on the possibility of metastatic disease as a cause of eyelid swelling, especially in patients with a history of cancer. It may also be the first sign of metastatic disease of an internal malignancy. A review of the literature is also presented.
Eyelids ; Metastatic to ; Neoplasm Metastasis ; Carcinoma ; brief historical notes, excludes case histories

Introduction: Sampling of non-palpable thyroid nodule under ultrasound guidance has been widely used, however less studies done in comparing the efficacy of technique between fine needle aspiration cytology (FNAC) and fine needle capillary sampling (FNCS) under ultrasound guidance. Objectives: This study aimed to determine the cytologic adequacy rates and sample quality obtained by both techniques under ultrasound guidance. Methods: Ultrasound‐guided thyroid nodule samplings were performed on 88 patients, 44 of them had FNAC and another 44 FNCS technique. The slides obtained were scored using a predetermined scoring system comparing five parameters: background blood; amount of cellular material; appropriate architecture retention, degree of cellular degeneration and cellular trauma. The results were analysed using chi square and binary logistic regression test. Results: Patient who underwent FNCS technique was 0.61times (95%CI) less likely to have large amount of background blood sample; 0.39times less likely to have sample with excellent architecture retention; 2.31times and 1.13times more likely to have sample with minimal cellular degeneration and minimal cellular trauma respectively when compare to FNAC. These were however not statistically significant. FNCS was 0.23times less likely to obtain sample with abundant cellular material compared to FNAC and it was statistically significant. Diagnostic adequacy rate was similar in both techniques and it was statistically significant. Conclusions Ultrasound‐guided FNAC and FNCS yielded comparable diagnostic adequacy rates. Our study did not prove a clear superiority of FNCS over FNAC or vice versa. Both techniques could be use in tandem to achieve better diagnostic accuracy.