A nodular tumor had grown from the palpebral conjunctiva over the lower lid margin of the left eye in a 62-year-old man during 5 months (Fig 1A). Histopathologically, a smaller portion around the lid margin resembled squamous cell carcinoma (Fig 1B, right). It merged into a major undifferentiated portion replacing the palpebral conjunctiva, with high mitotic activity (Fig 1B, left), focal glandular differentiation including mucin production (Fig 1C, Acian blue positive), and immunopositivity for cytokeratin-7 (Fig 1D) and carcinoembryonic antigen (CEA).
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