Case Report A Case of Muir-Torre Syndrome with Multiple Cancers of Bilateral Eyelids and Breast

Muir-Torre syndrome (MTS) is a clinical variant of hereditary non-polyposis colorectal cancer (Lynch syn-drome), and is defined as an autosomal dominant condition with simultaneous sebaceous neoplasms of the skin and visceral malignant disease resulting from germline muta-tions in DNA mismatch repair (MMR) genes [1]. This is a rare disease and the most common skin tumors associated with it are sebaceous adenomas, carcinomas, keratoac-anthomas, and basal-cell carcinomas with sebaceous dif-ferentiation [2]. The most common visceral malignancy is colorectal cancer. Although the exact incidence is unclear, there are only a few reports of a combination of eyelid tumors and breast cancer, and reports of MTS in Asian populations are rare. Here, we report a case of MTS that presented with multiple cancers of both eyelids and the breast with lack of mutS homolog (MSH) 2 staining. Case Report A 71-year-old woman presented with a swelling on her left upper eyelid in 2009. She also had a small mass on her right upper eyelid that been present for the previous 3 years. She had a history of breast cancer occurring in 1991, which was treated successfully without recurrence for 18 years. Laboratory data tests showed no remarkable changes. There was a significant family history of cancer; two of her brothers had also been diagnosed with cancers. Surgical excision and skin biopsy identified a sebaceous carcinoma in her right eyelid and a morphea-like basal cell carcinoma of her left eyelid (Fig. 1). Immunohistochemi-cal analysis was done using anti-mutL homolog (MLH)