A 62-year-old woman presented with a lesion on the medial aspect of the left upper lid, which was slowly enlarging over 2 years and darkened 6 months earlier. She admitted to having excessive sun exposure in the past, and her past medical history included hypertension, type II diabetes, and peripheral vascular disease. Her regular medications were insulin, metformin, simvastatin, ramipril, and clopidogrel.Examination revealed a curious lesion on the medial aspect of the left upper lid (Figure la). The lesion, which appeared cystic and lobulated, was mostly skin coloured with surface telangiectasia and purple-blue discoloration inferiorly. Although a benign lesion was suspected, the unusual appearance prompted excisional biopsy. Histopathological examination showed a papillary hidrocystoma with apocrine differentiation, featuring small lakes of blood within the myxoid material occupying the lumen (Figure lb).
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